Mastoid Epidermoid Tumor and Associated Dural Arteriovenous Fistula with Venous Sinus Occlusion

Jang W. Yoon, Youssef J. Hamade, Ramon Navarro, Benjamin L. Brown, Larry B Lundy, Rabih G. Tawk

Research output: Contribution to journalArticle

Abstract

Background: Dural arteriovenous fistula (DAVF) is an abnormal vascular connection between arterial and venous channels within dura mater. Although DAVFs have been linked to other types of intracranial tumors, this is the first case reporting the association between DAVF and an epidermoid tumor. Case Description: A middle-aged patient with chronic headache presented with Borden type II DAVF draining into the right transverse sigmoid junction and was also found to have an epidermoid tumor over the right mastoid. The patient underwent staged embolization of the fistula through both transvenous and transarterial routes. Continuous intraoperative venous pressure monitoring confirmed marked reduction in intracranial venous pressure, and the patient's symptoms completely resolved. However, the fistula still remained. The residual DAVF was then surgically disconnected, and the epidermoid tumor was resected in the same procedure. Conclusions: This case demonstrates a DAVF can be associated with an epidermoid tumor. Tumor can compromise the venous outflow, which can then lead to intracranial venous hypertension and development of the DAVF. Venous pressure monitoring offers an objective method to verify resolution of venous hypertension, which might correlate with resolution of clinical symptoms.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - 2017

Fingerprint

Central Nervous System Vascular Malformations
Mastoid
Venous Pressure
Neoplasms
Fistula
Dura Mater
Headache Disorders
Intracranial Hypertension
Intracranial Pressure
Sigmoid Colon
Blood Vessels
Hypertension

Keywords

  • Dural arteriovenous fistula
  • Epidermoid tumor
  • Intraoperative monitoring
  • Venous hypertension

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Mastoid Epidermoid Tumor and Associated Dural Arteriovenous Fistula with Venous Sinus Occlusion. / Yoon, Jang W.; Hamade, Youssef J.; Navarro, Ramon; Brown, Benjamin L.; Lundy, Larry B; Tawk, Rabih G.

In: World Neurosurgery, 2017.

Research output: Contribution to journalArticle

Yoon, Jang W. ; Hamade, Youssef J. ; Navarro, Ramon ; Brown, Benjamin L. ; Lundy, Larry B ; Tawk, Rabih G. / Mastoid Epidermoid Tumor and Associated Dural Arteriovenous Fistula with Venous Sinus Occlusion. In: World Neurosurgery. 2017.
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