Traumatic Arteriovenous Fistula of the Middle Meningeal Artery During Infancy
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Background and Importance
Traumatic arteriovenous fistulas (AVF) of the middle meningeal artery (MMA) are rare vascular lesions [1, 2]. After entering the middle cranial fossa through the foramen spinosum, the MMA courses laterally on the sphenoid bone in relation to an extensive network of variable small venous sinuses [3, 4]. This complex anatomy enables development of various traumatic MMA fistulas [2, 5, 6, 7, 8], but only three such cases involving the middle meningeal veins , pterygoid plexus , and sigmoid sinus  have been reported in pediatric patients. Fistulas of the MMA and carotid cavernous fistulas (CCF) [12, 13, 14, 15, 16, 17, 18, 19] constitute the majority of traumatic pediatric AVFs. They usually present months after the initial trauma. Traumatic MMA fistulas near the foramen spinosum may clinically mimic CCFs due to arterialization of the cavernous sinus (CS) . Symptoms relate to orbital venous congestion causing bruit, proptosis, chemosis,...
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conception and design: Dahl, Benndorf. Acquisition of data: R.H. Dahl, G. Benndorf. Analysis and interpretation of data: R.H. Dahl, G. Benndorf. Drafting the article: R.H. Dahl, G. Benndorf. Critically revising the article: all authors. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: G. Benndorf. Study supervision: G. Benndorf.
Compliance with ethical guidelines
Conflict of interest
R.H. Dahl, A.P. Born, M.L. Børresen and G. Benndorf declare that they have no competing interests.
For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. The patient’s parents consented to publication of the images and clinical information. Written informed consent was obtained.
- 3.Shi ZS, Ziegler J, Feng L, Gonzalez NR, Tateshima S, Jahan R, Martin NA, Viñuela F, Duckwiler GR. Middle cranial fossa sphenoidal region dural arteriovenous fistulas: Anatomic and treatment considerations. AJNR Am J Neuroradiol. 2013;34:373–80. https://doi.org/10.3174/ajnr.A3193 CrossRefGoogle Scholar
- 4.San Millán Ruíz D, Fasel JH, Rüfenacht DA, Gailloud P. The sphenoparietal sinus of breschet: Does it exist? An anatomic study. AJNR Am J Neuroradiol. 2004;25:112–20.Google Scholar
- 6.Smith JE, Epps J, Press HC Jr, Adair LB. Traumatic arteriovenous fistula between the middle meningeal artery and the sphenoparietal sinus: A case report and review of the world literature. J Natl Med Assoc. 1981;73:274–8.Google Scholar
- 17.Ciesielski T, Stefanowicz E, Brzozowski E. A case of post-traumatic carotid-cavernous fistula in a 9-year-old girl. Neurol Neurochir Pol. 1984;18:65–7.Google Scholar
- 18.Wajima D, Nakagawa I, Park HS, Yokoyama S, Wada T, Kichikawa K, Nakase H. Successful coil embolization of pediatric carotid cavernous fistula due to ruptured posttraumatic giant internal carotid artery aneurysm. World Neurosurg. 2017;98:871.e23-8. https://doi.org/10.1016/j.wneu.2016.11.137 CrossRefGoogle Scholar
- 19.Arseni C, Horvath L, Ciurea V, Simionescu N. Carotid-cavernous fistula in the child. Neurol Psychiatr (Bucur). 1978;16:29–32.Google Scholar