Presentation
Partial seizures affecting right upper limb for the last 3 days. No toxic habits or other previous medical history records.
Patient Data
Axial non-contrast CT: ovoid hyperdense intraparenchymal lesion with light surrounding edema in the left parietal lobe corresponding to a lobar hematoma.
Axial contrast CT: after iodinated contrast introduction, a prominent anomalous vascular structure is seen next to the hematoma.
Circle of Willis CT angiogram and MIP reconstructions: prominent anomalous vascular structures are seen next to the hematoma, as well as a dilated blood vessel outside the skull on the left temporoparietal side.
Bone window sagittal reconstruction: prominent vascular canal serving as an entrance point for the dilated extracranial blood vessel.
VRD 3D reconstruction: left superficial temporal artery running on the cranial surface.
Left ECA selective-angiography: dural arteriovenous fistula in the left parasagittal posterior parietal region of the brain, showing afferent arterial branches from the left superficial temporal artery. Enlarged cortical veins drain into the left transverse sinus.
Case Discussion
Intracranial dural arteriovenous fistula diagnosis was confirmed by DSA study after left ECA selective catheterization, which is the most common origin of the afferent arterial feeders.
This case illustrates a typical intracranial hemorrhage following venous hypertension in a complicated intracranial dural arteriovenous fistula, previously asymptomatic.
Unable to process the form. Check for errors and try again.