Transumbilical embolization of a congenital dural arteriovenous fistula atthe torcular herophili in a neonate

A neonate, in whom a congenital cerebral vascular anomaly had been diagnose d prenatally, exhibited progressive high-output congestive heart failure so on after birth. Cerebral angiography revealed a congenital dural arterioven ous fistula (AVF) with a huge dural lake located at the torcular herophili. In addition to the meningeal blood supply, an unusual pial blood supply fr om all cerebellar arteries was observed to feed the fistula. The patient wa s treated by repealed transarterial and transvenous embolization through th e umbilical venous route. To the authors' knowledge, neither the existence of a congenital dural AVF at the torcular herophili presenting with an enor mous pial blood supply or the technique of transumbilical venous interventi on has been reported in the literature.