Superficial Siderosis as a Manifestation of a Dural Arteriovenous Fistula

Abstract

Dural arteriovenous malformations (DAVF) represent 10-15% of cerebral vascular malformations 1. When symptomatic, their manifestations are directly related to the DAVF's location and its pattern of venous drainage. Neurological symptoms may present acutely or progressively, however intracranial hemorrhages occur spontaneously. No case of repeated intermittent hemorrhage due to an intracranial DAVF has been reported. Continuous or recurrent microhemorrhages into subarachnoid spaces are the proposed pathogenesis of superficial siderosis (SS), an uncommon and often unrecognized condition 2-6. Resultant hemosiderin deposits in the leptomeninges, pial and subpial layers progressively induce neuronal damage and are responsible for SS manifestations 2. Although other vascular pathologies have been reported in association with SS such as cavernous malformations, aneurysms and arteriovenous THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES

Intracranial dural arteriovenous fistula as a cause for symptomatic superficial siderosis: A report of two cases and review of the literature

“…There has only been one other case of SS due to an intracranial dAVF described in the literature. [ 38 ] This patient required open surgical obliteration of the fistula, which resulted in resolution of the patient's symptoms. We reported two additional cases of SS due to an intracranial dAVF which were treated using intra-arterial Onyx embolization.…”

“…Previously, a case of intracranial dural arteriovenous fistula (dAVF) treated with open surgery and a spinal dAVF as a cause of symptomatic SS have been reported as the putative cause for SS of CNS. [ 6 38 ] We will describe the second and third cases of intracranial dAVF as the cause of symptomatic intracranial SS and successful treatment of SS-associated dAVF with endovascular embolization.…”

Intracranial Dural Arteriovenous Fistulas: A Review

“…Resultant hemosiderin deposits in the leptomeninges, pial and subpial layers progressively induce neuronal damage and are responsible for SS manifestations. 17…”