Anesthetic management of infant with dural sinus malformation and high-flow arteriovenous fistula

Dural sinus malformations are rare congenital vascular abnormalities with variable anatomical features, and the lateral subtypes with arteriovenous fistulas may be difficult-to-treat. A perioperative particularity is that occlusion of high flow shunts in small children can cause hypertension and stroke, due to sustained shunt-induced high cardiac output. Therefore, anesthetic management focused on hemodynamic stability is crucial to avoid complications. Herein we report a successfully treated case of a 3-month-old infant with dural sinus malformations and high-flow arteriovenous fistula, evolving with periprocedural hypertension.