J Korean Neurosurg Soc.  2010 Feb;47(2):155-157. 10.3340/jkns.2010.47.2.155.

Anterior Cranial Fossa Dural Arteriovenous Fistulae Presenting as Subdural Hematoma

• Choi HJ
• Cho CW

• KMID: 1453150
• DOI: http://doi.org/10.3340/jkns.2010.47.2.155

Abstract

Anterior cranial fossa dural arteriovenous fistulae (DAVFs) are very rare and the bleeding rate is very high, especially in the presence of leptomeningeal draining vein and aneurysmal varix formation. A 85-year-old male patient presented with subdural hematoma (SDH). Magnetic resonance image (MRI) and transfemoral carotid angiography (TFCA) disclosed DAVF at the anterior cranial fossa with bilateral arterial feeders and leptomeningeal draining vein with varix formation. The lesion was treated by simple ligation of pial connecting vein using low frontal craniotomy. In comparison with DAVFs of the other sites, the anterior cranial fossa DAVF is difficult to manage by endovascular treatment due to not only the difficulty of transvenous access but the risk of visual impairment when using transarterial route. Surgical ligation of pial connecting vein is feasible and effective treatment.

Keyword

Anterior cranial fossa; Dural arteriovenous fistulae; Leptomeningeal draining vein; Craniotomy

MeSH Terms

Aged, 80 and over
Aneurysm
Angiography
Central Nervous System Vascular Malformations
Cranial Fossa, Anterior
Craniotomy
Hematoma, Subdural
Hemorrhage
Humans
Ligation
Magnetic Resonance Spectroscopy
Male
Varicose Veins
Veins
Vision Disorders