Ethmoidal dural arteriovenous fistula

Case contributed by Dr Andrew Lawson

Presentation

Sudden onset headache.

Patient Data

Age: 59
Gender: Female

CT Brain: Right frontal lobe haematoma with extension in the sub-dural space. Note the discrete region of low density within the anterior portion of the bleed.

CTA COW: large opacifying venous varix.

DSA (angiography)

Limited DSA views.

Ethmoidal dural AVF, with feeder coming off: Bilateral ophthalmic arteries - via right side crista galli. Bilateral external carotid arteries most likely from the ethmoidal and nasal cavity branches coming off of the internal maxillary arteries-R>L. Venous varicosity noted, with a large varix measuring approximately 12 mm x 8 mm to right of midline. Venous drainage noted into the rostral part of the superior sagital sinus. No further abnormality is identified.

Conclusions: Ethmoidal dural AVF with bilateral ophthalmic and external carotid feeders, as described.

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Case information

rID: 26554
Case created: 27th Dec 2013
Last edited: 2nd Oct 2015
Inclusion in quiz mode: Included

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