Dural Arteriovenous Fistula in the Anterior Cranial Fossa -Four Case Reports-

Abstract

Three of 4 cases of dural arteriovenous fistulas (DAVFs) in the anterior cranial fossa were detected incidentally by magnetic resonance (MR) imaging, and one case manifested as intracerebral hemorrhage. Cerebral angiography revealed fistulas located in the anterior cranial fossa. Three patients underwent surgery, and the fistulas were successfully obliterated. One patient with nonruptured DAVF requested conservative medical management. Incidental detection of asymptomatic or nonruptured DAVFs in the anterior cranial fossa has increased with the wider use of MR imaging. Increase in the size of a venous varix is the indicator for aggressive therapeutic intervention in a patient receiving conservative medical management for asymptomatic or nonruptured DAVFs in the anterior cranial fossa.

Clinical and Anatomic Insights From a Series of Ethmoidal Dural Arteriovenous Fistulas at Barrow Neurological Institute

“…Previously reported surgical series combined with our own results (Table 1) 6,[8][9][10][15][16][17][18][19] show that ethmoidal dAVFs are often discovered in older patients with a consistent male sex predilection (80% overall). Hemorrhagic presentation is common, 9, 10, 18 but modern series like our own and another from a tertiary referral center potentially underestimate this rate due to referral bias of incidentally discovered lesions.…”

Endovascular treatment of cribriform plate dural arteriovenous fistulas: technical difficulties and complications avoidance

“…The success rate of the surgical treatment is between 85% and 95%,4 14 with a rate of complication of 5.5–9% in experimented hands 3 14. Radiosurgical treatment is also described in isolated case reports in the literature 15 16. As for other cranial locations of dAVFs, radiosurgery has to be reserved for cases when open surgery and endovascular therapy are contraindicated because of low success rate and delayed cure.…”

Surgical Treatment of a Sylvian-Middle Fossa Dural Arteriovenous Fistula Draining into the Basal Vein of Rosenthal with Frontotemporal Craniotomy

“…6 In the present case, d-AVF was discovered by quarianopsia caused by cerebral infarction in the occipital lobe. Although cerebral blood flow or cerebral blood volume using single photon emission computed tomography (SPECT) or perfusion CT were not measured, we consider that dilated basal vein of Rosenthal might be related with ischemic change in the remote area or cause hemorrhage along the draining veins in the near future-therefore, this d-AVF was symptomatic and needed to be treated.…”

“…Tanei et al 6 suggested that an increase in the size of the venous varix is the indication for more aggressive therapeutic intervention if a patient requests conservative medical management for asymptomatic or nonruptured d-AVF in the anterior cranial fossa. 6 In the present case, d-AVF was discovered by quarianopsia caused by cerebral infarction in the occipital lobe.…”

“…1 d-AVF in the anterior circulation tends to manifest as intracranial hemorrhage. [2][3][4][5][6] In contrast, d-AVF in the posterior cranial fossa tends to manifest as brain stem infraction. [7][8][9][10][11] The purpose of treatment is to eliminate the blood flow from d-AVF to the leptomeningeal vein.…”