Dural arteriovenous fistula following cerebral venous sinus thrombosis in a patient with minimal change disease: A case report

A 78-year-old man presented with nephrotic syndrome and new-onset disorientation. Plasma D-dimer level was in-creased, and a lower leg deep vein thrombo-sis was identified on ultrasound. Histopatho-logic analysis of percutaneous renal biopsy samples confirmed the diagnosis of minimal change disease. Treatment with prednisone (20 mg/day), cyclosporine (50 mg/day), and anticoagulant therapy with edoxaban tosyl-ate hydrate led to the complete resolution of nephrotic syndrome after 4 weeks. Despite this, his disorientation persisted. Head CT and MRI have revealed cerebral venous sinus thrombosis and dural arteriovenous fistula, which was considered a possible complica-tion of nephrotic syndrome. Embolization dramatically improved his disorientation. This paper highlights that cerebral venous sinus thrombosis and dural arteriovenous fis-tula should always be considered in patients with nephrotic syndrome and new-onset dis -orientation.