Gadolinium-DTPA enhanced magnetic resonance imaging of dural sinus occlusion in dural arteriovenous malformation: a case report.

A case of dural arteriovenous malformation of the transverse sinus, is presented, with dural sinus occlusion imaged with gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). The patient, a 59-year-old man, had developed easy forgetfulness and frequent misreading over a four-month period; he had had episodic vertiginous attacks since 3 January 1992. Magnetic resonance (MR) imaging done on 21 January 1992 showed abnormally dilated subcortical vessels and a non-hemorrhagic venous ischemia in the subcortical white matter of the left posterior temporal lobe. Thrombosis of the left sigmoid sinus was seen. After administration of intravenous Gd-DTPA, dense enhancement in the left sigmoid sinus and abnormal serpiginous enhancement in the left temporal lobe were revealed. Left carotid angiography showed dural arteriovenous malformation in the posterior fossa, with non-opacification of the left transverse and sigmoid sinuses, plus forward venous drainage into left superior petrosal sinus. The focal neurologic deficits in this case from non-hemorrhagic venous ischemia in the subcortical white matter of the left posterior temporal lobe, and were secondary to venous hypertension.