Uchiyama Toshiya, Horiuchi Tetsuyoshi, Murata Takahiro, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Neurol Med Chir (Tokyo). 2011;51(9):642-4. doi: 10.2176/nmc.51.642.
A 40-year-old Brazilian man presented with headache followed by consciousness disturbance. Computed tomography showed subarachnoid hemorrhage with right frontal hematoma. Angiography revealed a dural arteriovenous fistula (dAVF) fed by the inferolateral trunk of the internal carotid artery and draining into the superficial sylvian vein with varix formation. The shunting point was directly obliterated through a pterional approach. Postoperative angiography showed complete disappearance of the fistula. A ventriculoperitoneal shunt was needed for normal pressure hydrocephalus during his hospitalization. The modified Rankin scale at discharge was grade 2 with mild cognitive dysfunction. This case of dAVF may represent congenital dAVF.
