Transverse-sigmoid dural arteriovenous fistula with subcortical calcification treated with transvenous embolization: A case report

We report a rare case of transverse-sigmoid dural arteriovenous fistula (TS-DAVF) with cortical venous reflux due to sinus occlusion combined with subcortical calcification. A 78-year-old man presented with a generalized tonic clonic seizure was transported by ambulance to our institute. He was neurologically normal after initial treatment for seizure. Neuroradiological examination indicated a left TS-DAVF with cortical venous reflux via the isolated sinus segment due to sinus occlusion. Prominent subcortical calcification was observed in the area of retrograde venous reflux. He underwent transarterial embolization followed by transvenous embolization for the isolated sinus by selective catheterization through the occluded ipsilateral sigmoid sinus, leading to complete obliteration without any complications. TS-DAVF with cerebral calcification is very rare and only 5 cases have previously reported. We report the clinical features and treatment strategies for this rare condition based on this case and other published studies.