Dural arteriovenous fistula associated with a glomus jugulare tumour presenting with only pulsatile tinnitus

Patric Darvie, Christopher Storey, Anil Nanda, Hugo Cuellar-Saenz

Research output: Contribution to journalArticle

Abstract

We present the second known case of a dural arteriovenous fistula (DAVF) associated with a glomus jugulare tumour in a 66-year-old man and the first with a presenting symptom of pulsatile tinnitus. The tumour occluded the left internal jugular vein at the bulb. Our patient opted for monitoring, but the tinnitus progressed and became debilitating, prompting him to proceed with embolisation of the tumour. Angiography revealed a DAVF of the left transverse sinus with retrograde flow. Embolisation of 80% of the tumour did not relieve symptoms. The patient returned for embolisation of the DAVF. Occlusion of the DAVF achieved symptomatic relief. A quandary develops during a procedure when the surgeon discovers that another intervention could satisfy the patient, while the patient is under anaesthesia. The higher flow in the DAVF likely causes the tinnitus in those with a patent sigmoid sinus, and embolisation of the DAVF alone could achieve relief.

Original languageEnglish (US)
Article number224860
JournalBMJ case reports
Volume2018
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

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Glomus Jugulare Tumor
Central Nervous System Vascular Malformations
Tinnitus
Transverse Sinuses
Neoplasms
Jugular Veins
Physiologic Monitoring
Sigmoid Colon
Angiography
Anesthesia

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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Dural arteriovenous fistula associated with a glomus jugulare tumour presenting with only pulsatile tinnitus. / Darvie, Patric; Storey, Christopher; Nanda, Anil; Cuellar-Saenz, Hugo.

In: BMJ case reports, Vol. 2018, 224860, 01.01.2018.

Research output: Contribution to journalArticle

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