Posttraumatic dural arteriovenous fistula

Case contributed by Dr Nick Tarasov

Presentation

Persistent headache resistant to painkillers. Severe head trauma 10 years ago.

Patient Data

Age: 45 years
Gender: Female

There are pronounced posttraumatic changes in the left cerebral hemisphere and to a lesser extent in the right frontal lobe. 

Previous left frontotemporoparietal craniotomy.

Ex vacuo dilatation of the left and third ventricles, thickening of the left frontal bone, and volume loss of the left cerebral peduncle (wallerian degeneration).

Vascular tangle with hemosiderin deposits within the left parietal region connecting terminal branches of the left MCA and convexity veins.

There is no diffusion restriction.

 

Case Discussion

There is a pathological connection between terminal branches of the left MCA and parietal convexity veins due to severe head trauma and brain decompression 10 years ago.
MRI findings are consistent with DAVF.

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