Dural arteriovenous malformations at the base of the anterior cranial fossa: report of nine cases

Abstract

Nine men with dural arteriovenous malformations (DAVM) at the base of the anterior cranial fossa are described. Four patients had intracerebral haemorrhage and four had seizures, associated with haemorrhage in two. In three cases the fistula was an incidental finding. In five cases the diagnosis could be made before angiography, on the basis of CT findings. Angiographically, venous drainage was always seen into ascending cortical veins. Five cases demonstrated drainage via the olfactory vein into the basal vein of Rosenthal; in four this way was the principal route of drainage. Five patients underwent surgery, the therapy of choice. One fistula closed spontaneously after angiography. Two patients refused treatment and one was not treated because of his poor general condition. Because arterial supply was usually bilateral, from small branches of the ophthalmic artery, embolisation seemed to be more dangerous. Compared to dural fistulae in other locations the DAVM of the anterior cranial fossa have a higher risk of complications and should be treated even if asymptomatic at the time of diagnosis.

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

“…1,4,5,7,8,[13][14][15][16] Direct drainage into the subfrontal cortical veins causes intracranial venous hypertension associated with a high incidence of intracranial hemorrhage and other clinical symptoms such as headache, seizure, and visual loss. 4) Evaluation of the intracranial venous hypertension is essential for deciding on the method of treatment for asymptomatic or nonruptured DAVF.…”

Venous Aneurysm Development Associated With a Dural Arteriovenous Fistula of the Anterior Cranial Fossa With Devastating Hemorrhage-Case Report-

“…Previous cases of DAVF in the anterior cranial fossa were primarily supplied from the ophthalmic artery and drained by the pial veins of the anterior frontal lobe into the SSS. 2,6,9) The mechanisms underlying changes in the venous drainage pattern may include stenosis or thrombosis of the vessel carrying the venous outflow, increased arterial flow, and the appearance of new fistulas or extension of the initial shunt. 5) An increase in hemodynamic stress may be involved in patients with progressive steno-occlusion of the venous drainers.…”

Treatment of Intracranial Dural Arteriovenous Fistulas: Current Strategies Based on Location and Hemodynamics, and Alternative Techniques of Transcatheter Embolization

“…Anterior fossa dural AVFs have a venous drainage pattern similar to that of tentorial dural AVFs with retrograde leptomeningeal drainage and are frequently associated with intracranial hemorrhage or nonhemorrhagic neurologic symptoms (Fig 13, Table 1) (3,61,62). The efficacy, potential risk, and difficulty of the various treatment options for anterior fossa dural AVFs are described in Table 9.…”