De novo multiple cerebral dural arteriovenous fistulas following treatment of cavernous sinus dural arteriovenous fistula and iatrogenic occlusion of sigmoid sinus：A case report

Abstract

We report an unusual case with de novo development of anterior condylar confluence dural arteriove-nous fistula（ACC‒DAVF）and transverse‒sigmoid（TS）DAVF one year after endovascular treatment of cavernous sinus（CS）DAVF. A 74‒year‒old female was admitted to our hospital after presenting with headache. The diagnostic magnetic resonance imaging and digital subtraction angiography（DSA）revealed CS‒DAVF（Borden type III）. Transvenous embolization（TVE）for this lesion failed, but DSA at two weeks after the intervention showed disappearance of the CS‒DAVF and occlusion of the ipsilateral sigmoid sinus. However, one‒year follow‒up DSA revealed de novo ipsilateral ACC‒DAVF（Borden type I）and TS‒ DAVF（Borden type II）. TVE and transarterial embolization（TAE）were successfully performed for the TS‒DAVF. No recurrence was seen at the one‒year follow‒up. After treatment of a DAVF, especially combined with iatrogenic occlusion of sigmoid sinus, de novo DAVFs may occur at other sites. Thus, careful radiological follow‒up is recommended.