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Remodeling of venous drainage after the treatment of dural sinus malformation with arteriovenous shunts in a neonate: a case report and literature review

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Abstract

Dural sinus malformations (DSMs) are rare congenital vascular diseases characterized by a giant venous pouch with or without arteriovenous shunts. We present a neonatal case of DSM that was diagnosed prenatally and treated via endovascular intervention in the early postnatal period. The patient presented with a large DSM involving the torcular Herophilion prenatal magnetic resonance imaging (MRI). Enlargement of the head circumference and respiratory failure rapidly progressed after birth. On the 5th day after birth, the neonate underwent endovascular occlusion via the umbilical artery. The arteriovenous shunt was occluded, and the reflux from the enlarged venous pouch to the dural sinus was decreased. No additional procedure other than ventriculoperitoneal shunting was required. The neonate’s development slowly caught up to normal parameters. Follow-up MRI demonstrated the successful development of the venous drainage system. DSMs are characterized by an abnormally dilated dural sinus, which can block the venous return and ultimately increase intracranial pressure and cerebral ischemia. Long-term follow-up indicates that an abnormally developed dural sinus can be reconstructed by appropriate and timely treatment.

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Data availability

Data from this manuscript are available upon reasonable request.

Abbreviations

AV shunts:

Arteriovenous shunts

CSF:

Cerebrospinal fluid

DSM:

Dural sinus malformation

MRI:

Magnetic resonance imaging

NBCA:

N-butyl-2-cyanoacrylate

SD:

Standard deviation

SOV:

Superior orbital vein

SSS:

Superior sagittal sinus

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Acknowledgements

We thank Enago for the English review and editing.

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Authors and Affiliations

  1. Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Ibaraki, 305-8575, Japan

    Sho Hanai, Ai Muroi, Masayuki Sato, Yuji Matsumaru & Eiichi Ishikawa

  2. Department of Pediatrics, Institute of Medicine, University of Tsukuba, Ibaraki, 305-8575, Japan

    Daisuke Hitaka & Takashi Murakami

  3. Division of Stroke Prevention and Treatment, Institute of Medicine, University of Tsukuba, Ibaraki, 305-8575, Japan

    Yuji Matsumaru

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  1. Sho Hanai
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  2. Ai Muroi
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  3. Daisuke Hitaka
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  4. Takashi Murakami
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  5. Masayuki Sato
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  6. Yuji Matsumaru
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  7. Eiichi Ishikawa
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Contributions

S.H. and A.M. wrote the main manuscript and figures. D.H. and T.M. contributed the treatment and advised the more appropriate information to write this manuscript. M.S., Y.M. and E.I. contributed the intervention treatment and advised the more appropriate information to write this manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Ai Muroi.

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Ethics approval

IRB approval for a case report is waived at the Tsukuba University Hospital.

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Written informed consent was obtained from the patient’s mother for publication of this case report and accompanying images.

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The authors declare no competing interests.

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Hanai, S., Muroi, A., Hitaka, D. et al. Remodeling of venous drainage after the treatment of dural sinus malformation with arteriovenous shunts in a neonate: a case report and literature review. Childs Nerv Syst 39, 2245–2249 (2023). https://doi.org/10.1007/s00381-023-05961-w

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  • DOI: https://doi.org/10.1007/s00381-023-05961-w

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