Embolization of a traumatic arteriovenous fistula between the middle meningeal artery and middle meningeal vein in a child with pulsatile tinnitus.

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Abstract

Traumatic arteriovenous fistulas (AVFs) involving the middle meningeal artery (MMA) are uncommon lesions and rare in the pediatric population. An adolescent with headaches developed a bruit and a rhythmic "swooshing" noise in the left ear 9 weeks after a traumatic brain injury involving a left temporal bone fracture. An MRA of the brain demonstrated an enlarged left MMA and arterialized flow in the left middle meningeal vein (MMV), suggestive of an AVF. Cerebral angiography confirmed and characterized the left MMA-MMV fistula, which drained into the pterygoid plexus. The patient underwent transarterial coil embolization, with successful obliteration of the fistulous connection, and her tinnitus resolved. This case illustrates the importance of recognizing a post-traumatic AVF in a pediatric patient with pulsatile tinnitus, and that endovascular treatment by coil embolization is a safe and effective treatment option.

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Author and article information

Journal

Journal ID (iso-abbrev): Childs Nerv Syst

Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

Publisher: Springer Science and Business Media LLC

ISSN (Electronic): 1433-0350

ISSN (Print): 0256-7040

Publication date (Electronic): March 2018

Volume: 34

Issue: 3

Affiliations

[1 ] Division of Interventional Neuroradiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

[2 ] Department of Neurology, Children's National Medical Center, Washington, DC, USA.

[3 ] Department of Radiology, Children's National Medical Center, Washington, DC, USA.

[4 ] Division of Interventional Neuroradiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. msmit135@jhmi.edu.

[5 ] Department of Radiology, Children's National Medical Center, Washington, DC, USA. msmit135@jhmi.edu.

[6 ] The Johns Hopkins Hospital, Bloomberg Building Room 7218, 1800 Orleans Street, Baltimore, MD, 21287, USA. msmit135@jhmi.edu.

Article

Publisher Item ID: 10.1007/s00381-017-3665-x

DOI: 10.1007/s00381-017-3665-x

PubMed ID: 29170838

SO-VID: b4aa8146-8564-49e0-9051-d1958ddc1a5b

History

Keywords: Middle meningeal artery,Arteriovenous fistula,Coil embolization,Pediatric

Data availability:

Keywords: Middle meningeal artery, Arteriovenous fistula, Coil embolization, Pediatric

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