Management of midline dural sinus malformations and review of the literature

Abstract

Early diagnosis and treatment, if necessary, of DSMs are critical to prevent cardiac failure or parenchymal injury from chronic venous hypertension. Management should be decided on individual case basis depending on the angioarchitecture and progression of the lesion and can involve observation, endovascular embolization, surgical interventions, or a combination of treatments. A personalized approach to treating these variable lesions can be associated with good outcomes.

Spontaneous Resolution of Congenital Dural Venous Sinus Ectasia Associated With Polymicrogyria—Case Report

“…The literature covering the topic of giant dural sinus ectasia consists mostly of case reports, in which clinical presentation and outcome differ significantly. The clinical manifestations in the neonatal period include macrocrania, hydrocephalus, seizures, consumptive coagulopathy, spontaneous thrombosis, and cardiac failure ( 2 , 5 ). None of the above-mentioned manifestations was observed in our patient directly after birth.…”

“…None of the above-mentioned manifestations was observed in our patient directly after birth. The prognosis for patients with dural sinus malformations is often poor, with mortality ranging between 38 and 67% ( 2 ). However, more recent publications report patients with no or little neurological deficits on follow-up examinations ( 3 , 10 ).…”

“…It may be associated with meningeal arteriovenous fistula, generalized ischemia, increased intracranial pressure leading to compression of the central nervous system (CNS), intracranial bleeding, consumptive coagulopathy, and circulatory failure (1). Prognosis for survival and psychomotor development is uncertain (1)(2)(3). We present the first case report of a patient with congenital ectasia of the confluence of sinuses with thrombosis diagnosed prenatally, which might have led to bilateral polymicrogyria (PMG) development.…”

Dural Sinus Arteriovenous Malformation in the Fetus. Case Report and Discussion of the Literature

“…Equally, other reports describe a variable outcome in pediatric cases, with the lesion progressively decreasing in time in some of them, but presenting in others with cardiac failure and the necessity of endovascular embolizations with variable neurological impact [ 5 , 6 ].…”