349 - Endovascular Treatment of Pediatric Dural Sinus Malformations: A Twenty-Year Multi-Center Case Series

Wednesday, April 15, 2026

12:00 PM - 12:09 PM ET

Presenting Author(s)

AS

Arian Shahidi, MD

Radiology Postdoctoral Researcher
Northwestern University, Feinberg School of Medicine, United States

Author/Co-author(s)

FR

Flavio Requejo, MD

Neurointerventional Radiologist/ Head of the Department of Neurointerventional Radiology
Department of Pediatric Interventional Neuroradiology, Hospital de Pediatría Prof. Dr. Juan P Garrahan, Argentina
MG

María L. Gonzalez, MD

Neurointerventional Radiologist
Department of Interventional Radiology, Hospital Nacional de Pediatria JP Garrahan, Argentina
AA

Anas S. Al-Smadi, MD

Neurointerventional Radiologist
University of Illinois College of Medicine Peoria, United States
DC

Donald R. Cantrell, MD, PhD

Assistant Professor of Radiology
Northwestern University, Feinberg School of Medicine, United States
RA

Ramez N. Abdalla, MD, PhD

Assistant Professor of Radiology
Northwestern University, Feinberg School of Medicine, United States
SA

Sameer A. Ansari, MD, PhD

Professor of Radiology, Neurology, Neurological Surgery
Northwestern Medicine, United States
AS

Ali Shaibani, MD, MBA

Professor of Radiology
Northwestern University, Feinberg School of Medicine, United States

Purpose: Dural sinus malformation (DSM) is a rare congenital vascular anomaly of dural venous sinuses, classified as midline or lateral. DSMs feature marked sinus dilation that can cause venous hypertension, hydrocephalus, heart failure, and death. The associated morbidity imposes a significant burden on patients and families, as irreversible neurological injury may ensue without timely recognition and intervention.
The existing DSM studies are limited to case reports and small series. Endovascular embolization is the mainstay of treatment, though surgery is occasionally required. We present a multicenter series of 14 pediatric DSMs, highlighting presentations, embolization strategies, and outcomes.

Materials and Methods: The data for this retrospective study were collected from two tertiary centers in Argentina and the United States. Prior to data collection, approval was obtained from Comité de Ética en Investigación (Research Ethics Committee - CEI) and the institutional review board (IRB). The collected data consisted of demographics (age and gender), symptoms, prenatal diagnosis, imaging modalities used [ultrasound, computed tomography (CT), magnetic resonance imaging (MRI)], angiographic findings and classification (involved sinuses, arterial feeders, retrograde/antegrade flow, and cortical veins reflux), number of embolization sessions, used materials, angiographic and clinical outcomes. During the preparation of this work, the authors used ChatGPT (GPT-5, OpenAI) to improve grammar, spelling, and readability.

Results: Fourteen pediatric DSM patients were identified across two centers. Median presentation was within the first year of life (5–13 months). Clinical features included macrocephaly, apnea, heart failure, cranial masses, seizures, and focal deficits; three were diagnosed prenatally. Most were midline torcular DSMs, supplied by meningeal branches of the external carotid and vertebral arteries.

Conclusion: DSM is a rare but severe pediatric malformation, typically presenting in early life with life-threatening complications. Endovascular embolization is effective but often requires staged, multimodal treatment. Despite generally good outcomes, morbidity and mortality remain significant, underscoring the need for early recognition, tailored therapy, and long-term follow-up.