Carlos G. Seañez, Neurosurgery and Neurologic Endovascular Therapy Service, “Dr. Jose E. Gonzalez” University Hospital, Universidad Autonóma de Nuevo León, Monterrey, Nuevo Leon, Mexico Jesus A. Morales, Neurosurgery and Neurologic Endovascular Therapy Service, “Dr. Jose E. Gonzalez” University Hospital, Universidad Autonóma de Nuevo León, Monterrey, Nuevo Leon, Mexico Valeria González, Neurosurgery and Neurologic Endovascular Therapy Service, “Dr. Jose E. Gonzalez” University Hospital, Universidad Autonóma de Nuevo León, Monterrey, Nuevo Leon, Mexico Luis F. Checca, Neurosurgery and Neurologic Endovascular Therapy Service, “Dr. Jose E. Gonzalez” University Hospital, Universidad Autonóma de Nuevo León, Monterrey, Nuevo Leon, Mexico Angel R. Martínez-Ponce de León, Neurosurgery and Neurologic Endovascular Therapy Service, “Dr. Jose E. Gonzalez” University Hospital, Universidad Autonóma de Nuevo León, Monterrey, Nuevo Leon, Mexico


Introduction: Dural arteriovenous fistulas are abnormal communications between the arterial and dural sinus vessels or the cortical veins. Multiple dural arteriovenous fistulae have an incidence rate of 6-9%. Their pathophysiology is poorly understood, although there is a consensus on three theories for their formation. The systemic infection caused by SARS-CoV-2 in its severe presentations is associated with a pro-inflammatory state that represents an ideal condition for complications of pre-existing cerebrovascular diseases. Digital subtraction angiography is considered the gold standard to understand the architecture of this lesion. Case Presentation: The patient was a 49-year-old male with a history of multiple head trauma, a 20-year history of tobacco use, tinnitus, and gradual deterioration of higher mental functions. On admission, he presented respiratory distress and was dependent on oxygen. Conclusion: This case presents a bleak picture of the overlap between two devastating diseases as a clear example of the direct and collateral damage of the SARS-CoV-2 pandemic. Coronavirus disease in 2019 does not exclude a previous underlying pathology.



Keywords: Multiple dural arteriovenous fistulae. SARS-CoV-2. Dural venous sinuses. Cortical veins.