Chen Zhi, Zhu Gang, Feng Hua, Tang Weihua, Wang Xianrong
Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Surg Neurol. 2008 Mar;69(3):318-21. doi: 10.1016/j.surneu.2006.12.057. Epub 2007 Aug 17.
Dural arteriovenous fistula (DAVF) accompanied by intracranial aneurysms is an extremely rare situation.
A 65-year-old man presented with sudden loss of consciousness for about half an hour. Computed tomographic scan of the brain showed subarachnoid hemorrhage. Angiogram revealed an ophthalmic aneurysm. In addition, a DAVF located in the anterior cranial fossa was also found. The ruptured aneurysm was completely occluded by coil embolization and the DAVF of the anterior cranial fossa was treated with gamma knife radiosurgery after an uneventful postoperative course. The patient was managed nonoperatively and discharged with close follow-up.
An unusual case of anterior cranial fossa DAVF associated with a ruptured ophthalmic aneurysm is reported. We feel special consideration may be required in deciding the priority of treatment in such cases.