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.

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.

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

Why vote for Mount Sinai Kravis Children's Hospital in U.S. News & World Report’s Best Children’s Hospital rankings?

  • We offer an internationally recognized pediatric cerebrovascular program to evaluate and treat children with AVMs, vein of Galen malformations, aneurysms, and other cerebrovascular disorders in collaboration with pediatric neurology, neurosurgery, and interventional neuroradiology.

  • We have the largest pediatric surgical epilepsy program in New York, offering the full spectrum of management options for pediatric epilepsy including groundbreaking work in the area of neuromodulation. Mount Sinai was the first hospital to implant a responsive neurostimulator for uncontrolled epilepsy in a child.

  • We offer comprehensive multidisciplinary programs for children with brain and spine tumors, spasticity/cerebral palsy, spina bifida, Chiari malformation, and craniofacial anomalies including craniosynostosis.

  • We have expertise in minimally invasive neurosurgery including neuroendoscopy, robotics and image guided surgery.

  • We are internationally recognized for the evaluation and endovascular or comprehensive treatment of children with complex head and neck vascular disorders including venous malformations, lymphatic malformations, and arteriovenous malformations of the head and neck area. We also conduct breakthrough research in these areas.

  • Our unique pediatric neurology subspecialty programs include headache, autoimmune neurology, neurofibromatosis, and neuro-oncology.

  • We have a clinical collaboration with the largest pediatric newborn screening referral program in New York State and one of the largest metabolic disorders programs in the United States within the Department of Genetics and Genomics. It offers several neuro-centric specialty areas including the fragile X syndrome clinic, mitochondrial medicine program, lysosomal storage disease program, and inherited metabolic disorders program.

  • Our robust clinical program in pediatric neuro-behavioral disorders includes autism spectrum disorder in association with the nationally recognized Seaver Autism Center, which specializes in autism genetics and novel therapies.