Dural arteriovenous fistulas (DAVFs) are rare but significant intracranial vascular malformations that are usually idiopathic and can lead to severe complications like venous hypertension and intracranial hemorrhage. We present 2 cases of DAVF occurring after venous sinus stenting (VSS) for presumed idiopathic intracranial hypertension (IIH) in a 51-year-old and a 52-year-old female. In both patients, Cognard type 1 DAVF was detected by Catheter angiography and successfully obliterated with Onyx™ embolization. These cases suggest that VSS may either unmask pre-existing DAVFs by altering intracranial pressure dynamics or induce new fistula formation by angiogenic factors or stent-induced hemodynamic changes. Clinicians should maintain an index of suspicion for DAVF in patients with persistent symptoms post-VSS and catheter angiography might be needed to detect the DAVFs.
Keywords: Case report; Dural arteriovenous fistula; Idiopathic intracranial hypertension; Venous sinus stent.
© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.