Transumbilical embolization of a congenital dural arteriovenous fistula at the torcular herophili in a neonate. Case report

J Neurosurg. 1999 May;90(5):964-9. doi: 10.3171/jns.1999.90.5.0964.


A neonate, in whom a congenital cerebral vascular anomaly had been diagnosed prenatally, exhibited progressive high-output congestive heart failure soon after birth. Cerebral angiography revealed a congenital dural arteriovenous fistula (AVF) with a huge dural lake located at the torcular herophili. In addition to the meningeal blood supply, an unusual pial blood supply from all cerebellar arteries was observed to feed the fistula. The patient was treated by repeated transarterial and transvenous embolization through the umbilical venous route. To the authors' knowledge, neither the existence of a congenital dural AVF at the torcular herophili presenting with an enormous pial blood supply or the technique of trans-umbilical venous intervention has been reported in the literature.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Arteriovenous Fistula / congenital
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / therapy*
  • Cerebellum / blood supply*
  • Cerebral Angiography
  • Dura Mater / blood supply*
  • Embolization, Therapeutic*
  • Humans
  • Infant, Newborn
  • Pia Mater / blood supply*
  • Umbilical Veins