A Case Series of Ethmoidal Dural Arteriovenous Fistulas Treated by Endovascular Embolization with Onyx

Abstract

Introduction: Ethmoidal dural arteriovenous fistulas (eDAVFs) are an unusual type of intracranial vascular lesion that commonly present with acute haemorrhage.

Aim: We presented 3 cases of ethmoidal DAVFs treated effectively by endovascular embolization with Onyx.

Results: 3 patients hospitalized by reasons of stroke (2 cases) and vision impairment of the right eye (1 case). The digital subtraction angiography (DSA) showed the fistulas supplied by ethmoidal branches of the ophthalmic arteries (3 cases) and an additional supply from the ethmoidal branches of the internal maxillary artery (1 case). The cortical venous drainage was dilated and flowed to the superior sagittal sinus. The superselective microcatheterization through the ophthalmic artery allowed injection of Onyx sufficient plug around the distal end of the catheter without any complications.

Conclusion: eDAVFs with neurologic complications could be treated effectively by endovascular embolization with Onyx.

Keywords: Ethmoidal dural arteriovenous fistulas; Onyx; endovascular embolization.