Pharyngo-tympano-stapedial middle meningeal artery variant supply to a falcotentorial dural arteriovenous fistula

We report the case of a middle-aged patient with severe, daily headache who presented to our institution for angiography and treatment. CT angiography and MRI demonstrated an enlarged left middle meningeal artery coursing to a large venous varix in the falcotentorial region. Dural arteriovenous fistula was confirmed by subsequent cerebral angiography. Endovascular treatment was performed but without complete obliteration of the fistula. Follow-up angiography demonstrated parasitized arterial supply from a right middle meningeal artery arising from the proximal cervical internal carotid artery coursing through the middle ear consistent with a PTS-MMA variant. The fistula was then treated surgically without recurrence at the 6-month follow-up.

Source: Journal of NeuroInterventional Surgery - November 14, 2022 Category: Neurosurgery Authors: Baker, A., Raygor, K., Caton, M. T., Narsinh, K. H., Smith, E., Dowd, C. F., Cooke, D. L., Higashida, R. T., Amans, M. R., Abla, A. A., Hetts, S. W. Tags: Hemorrhagic stroke Source Type: research