Prenatal Three-Dimensional Ultrasound Diagnosis of Dural Sinus Arteriovenous Malformation: An Unusual Case Report

Background: Dural sinus arteriovenous malformation is an uncommon intracranial vascular malformation. The affected cases may suffer from severe neurological injury. Prenatal ultrasound has been used to diagnose fetal intracranial vascular abnormality, but prenatal three-dimensional (3D) ultrasound presents a very rare anomaly; an arteriovenous malformation of the dural sinus has not been reported.Objective: This study aimed to emphasize the diagnostic value of 3D ultrasound in the fetus with dural sinus arteriovenous malformation.Case Presentation: A 38-year-old woman was referred for targeted fetal ultrasonography at 37 weeks of gestation due to an ultrasound that showed a cystic lesion in the posterior cranial fossa. The fetus demonstrated obvious dilatation of the torcular herophili, bilateral transverse sinuses, and bilateral sigmoid sinuses, appearing as a novel bull's horn sign on 3D ultrasound. After birth, cerebral angiography confirmed the diagnosis of dural arteriovenous fistula (DAVF) in the occipital sinus region.Conclusion: 3D ultrasound is an appealing method for prenatal diagnosis of dural sinus arteriovenous malformation.