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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(01): 183-189
DOI: 10.1055/s-0044-1792162
Case Report

Endovascular Approach to Concurrent Anterior Cranial Fossa Dural AVF and Concurrent Flow-Related Ophthalmic Artery Aneurysm: A Case Study

Vikas Chandra Jha
1   Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India
,
Rahul Jain 
1   Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India
,
Vivek Saran Sinha
1   Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India
,
Nitish Kumar
1   Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India
,
Gaurav Verma
1   Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India
,
Sangam Jha
1   Department of Neurosurgery, All India Institute of Medical Sciences, Patna, Bihar, India
› Author Affiliations Funding None.
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Abstract

Dural arteriovenous fistulas (DAVFs) with concurrent flow-related ophthalmic artery aneurysms, particularly intraorbital aneurysms, are rare. Retrograde cortical blood flow and sinus thrombosis heighten the risk of rupture and optic nerve compression, yet treatment strategies remain poorly defined. This study aims to explore effective management for these complex cases. A 66-year-old hypertensive man presented with an acute severe headache, loss of consciousness, and decreased vision in the left eye. Imaging revealed a left frontal intracranial hemorrhage and an anterior cranial fossa DAVF with a left ophthalmic artery aneurysm. Endovascular embolization via the left ophthalmic artery, using a microcatheter distal to the aneurysm and controlled reflux of glue injection (N-butyl cyanoacrylate and lipiodol), successfully treated the DAVF and ophthalmic artery aneurysm. Visual acuity improved to finger counting at 1 foot, with no residual DAVF at 6 months. This case demonstrates that controlled glue embolization is a viable alternative when microsurgery is not feasible due to complex anatomy.

Keywords

concurrent ophthalmic aneurysm - dural arteriovenous fistula - glue embolization - visual acuity

Authors' Contributions

V.C.J., V.S.S., and N.K. were the operating surgeons. V.C.J., V.S.S., N.K., G.V., and R.J. conducted the literature search. V.S.S., N.K., G.V., and R.J. prepared the manuscript. V.C.J., V.S.S., N.K., and R.J. edited the final manuscript. V.S.S., N.K., G.V., and R.J. performed the patient's follow-up. All the authors have read and approved the manuscript.


Patients' Consent

The patient gave written informed consent to participate and have their medical records used for research and academic purposes.




Publication History

Article published online:
25 November 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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