Intracranial dural arteriovenous fistula

Case contributed by Martin Saenz Aguirre

Presentation

Partial seizures affecting right upper limb for the last 3 days. No toxic habits or other previous medical history records.

Patient Data

Age: 20 years
Gender: Female

Axial non-contrast CT: ovoid hyperdense intraparenchymal lesion with light surrounding edema in the left parietal lobe corresponding to a lobar hematoma.

Axial contrast CT: after iodinated contrast introduction, a prominent anomalous vascular structure is seen next to the hematoma.

CT

Cerebral CT angiography

Circle of Willis CT angiogram and MIP reconstructions: prominent anomalous vascular structures are seen next to the hematoma, as well as a dilated blood vessel outside the skull on the left temporoparietal side.

Bone window sagittal reconstruction: prominent vascular canal serving as an entrance point for the dilated extracranial blood vessel.

VRD 3D reconstruction: left superficial temporal artery running on the cranial surface.

DSA (angiography)

Left ECA selective-angiography: dural arteriovenous fistula in the left parasagittal posterior parietal region of the brain, showing afferent arterial branches from the left superficial temporal artery. Enlarged cortical veins drain into the left transverse sinus.

Case Discussion

Intracranial dural arteriovenous fistula diagnosis was confirmed by DSA study after left ECA selective catheterization, which is the most common origin of the afferent arterial feeders.

This case illustrates a typical intracranial hemorrhage following venous hypertension in a complicated intracranial dural arteriovenous fistula, previously asymptomatic.

PlayAdd to Share

Case information

rID: 68981
Published: 27th Jun 2019
Last edited: 27th Jun 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.