Hypoglossal Canal Dural Arteriovenous Fistula Induced after Mechanical Thrombectomy for Acute Ischemic Stroke

Objective: In this study, we report a patient in whom a dural arteriovenous fistula (dAVF) developed after mechanical thrombectomy for acute ischemic stroke, and embolization was performed. Case Presentation: The patient was a 44-year-old male. He was brought to the emergency room of our hospital by ambulance with cervical pain. Head MRI revealed ischemic stroke related to right internal carotid artery occlusion. Mechanical thrombectomy was performed and thrombolysis in cerebral infarction (TICI) 2b recanalization was achieved. Middle cerebral artery (M2) occlusion and internal carotid artery dissection were observed. Follow-up was conducted. The postoperative course was favorable, and he was referred to another hospital for rehabilitation. However, cerebral angiography 4 months after surgery showed a dAVF. Transarterial embolization was performed. The postoperative course was uneventful and she was discharged. Conclusion: In the present case, dissection-related dilation/elevation of the internal carotid artery may have resulted in venous compression, leading to the development of a dAVF. We could confirm these serial changes in images before and after its development.