Infantile Dural Sinus Malformation Curative Embolization in Two Stages With Scepter Mini Balloon Microcatheter

A 2-MONTH-OLD female neonate presented to Mount Sinai Kravis Children’s Hospital for life-saving treatment of dural sinus malformation, hydrocephalus, and acute intracranial hemorrhage. See how a team led by Johanna T. Fifi, MD, performed a staged transarterial endovascular embolization with no subsequent neurological deficits and achieved complete obliteration of the dural sinus malformation.

2 min read

Mount Sinai is home to the world’s leading physicians in pediatric vascular malformations of the brain, head and neck, spine, and spinal cord. In 2021, the pediatric cerebrovascular team treated 144 cases (118 in children 18 and younger, and 26 in young adults 18 to 21 years of age).

Dr. Fifi is newly named Co-Director of the Department of Neurosurgery’s Pediatric Cerebrovascular Disorders Program at Kravis Children’s Hospital. She partners with internationally renowned Co-Director Alejandro Berenstein, MD, in overseeing a highly recognized program in diagnosing, managing, treating, and researching brain vascular malformations (including vein of Galen malformations), head and neck vascular malformations, aneurysms, and occlusive vascular diseases. Dr. Fifi is also Associate Professor of Neurosurgery, Neurology, and Diagnostic, Molecular and Interventional Radiology at the Icahn School of Medicine at Mount Sinai, and Associate Director of the Cerebrovascular Center.

  • 144 cases of pediatric vascular malformations treated in 2021

The patient was transferred from outside the country for treatment at Mount Sinai, where imaging revealed the dilated sinus, measuring 8.1 by 4.9 by 6.4 centimeters, accompanied by increased thrombus in the sinus with intraventricular hemorrhage, areas of parenchymal damage, and continued hydrocephalus.

Common carotid artery angiograms showed multiple bilateral arterial feeding arteries, including the middle meningeal parietal branches, occipital artery transosseous branches, and posterior meningeal branches. The fistulas entered the malformation around the region of the torcula.

Watch the video case presentation here.

Infantile Dural Sinus Malformation Curative Embolization in Two Stages with Scepter Mini Balloon Microcatheter