• World Neurosurg · Dec 2019

    Case Reports

    Ruptured Posterior Inferior Cerebellar Artery Dural Fistula after Vestibular Schwannoma Resection.

    • Christopher S Graffeo, Avital Perry, Anthony L Mikula, Waleed Brinjikji, and Leonardo Rangel Castilla.
    • Departments of Neurologic Surgery and Radiology, Mayo Clinic, Rochester, Minnesota, USA.
    • World Neurosurg. 2019 Dec 1; 132: 397.

    AbstractA 50-year-old man with a history of left-sided retrosigmoid craniotomy for vestibular schwannoma (VS) resection 19 years prior presented with severe headache and left cerebellopontine angle subarachnoid hemorrhage (SAH). Digital subtraction angiography demonstrated a dissected, nonfunctional left posterior inferior cerebellar artery with direct fistulization at the left transverse sinus (Video 1). The lesion was treated with endovascular Onyx embolization. The patient recovered without neurologic deficit. Five additional cases of new dural arteriovenous fistula arising after VS resection have been described; we report the first such case presenting with SAH, suggesting that postoperative magnetic resonance angiography may be of value in long-term VS follow-up imaging protocols.Copyright © 2019 Elsevier Inc. All rights reserved.

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