Case study: traumatic dural arteriovenous fistula - an opportunity for AI to accelerate diagnosis

• DOI: 10.20935/acadmed7622
• Publication Date: 2025-03-21T13:38:31Z
• Authors: Kyle McGrath; Serban Negoita; Zachary Sorrentino; Dimitri Laurent; Kevin Pierre; Spaulding Solar; Brandon Lucke-Wold; Ibrahim Tuna; Nohra Chalouhi; Matthew Koch

Traumatic dural arteriovenous fistula (dAVF) formation rarely occurs following calvarial fractures. Traumatic dAVFs, if untreated, may rupture, causing devastating intracranial hemorrhage, and the presence of cortical venous drainage increases the risk of rupture and mortality. A female in her sixth decade of life developed a traumatic dAVF of the middle meningeal artery (MMA) after being hit by a motor vehicle. The MMA dAVF drained into the superior petrosal sinus and vein of the Labbe consistent with a Cognard grade 3 lesion. This was successfully obliterated with transarterial endovascular embolization, and she remained at her neurologic baseline. Formation of dAVFs between the MMA and vein of Labbe can occur as the intradural segment of Labbe often runs in the anterior tentorium, bringing it in close proximity to the MMA. Transarterial approaches for endovascular treatment of MMA dAVFs can achieve high cure rates due to the non-tortuous course of the MMA. Development of an artificial intelligence tool to diagnose dAVFs using non-invasive imaging could streamline diagnosis and treatment of these lesions.