Case ReportDural Arteriovenous Fistula Mimicking a Supratentorial Tumor
Introduction
Intracranial dural arteriovenous fistula (dAVF) is a rare and heterogeneous disease. The pathophysiology of dAVF is not completely understood and their radiologic diagnosis can be challenging. dAVF are known to be potentially associated with retrograde venous blood flow and venous congestion. We present the unique case of a patient presenting with a delimited supratentorial, corticosubcortical contrast-enhancing lesion associated with a dAVF, focusing on long-term radiologic follow-up after microsurgical dAVF surgical occlusion treatment.
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Case Report
A healthy 56-year-old woman was admitted to our neurosurgical department with a new onset of repeated secondary generalized tonico-clonic seizures. Initial neurologic examination, after seizure control, showed a mild right leg weakness. Initial brain magnetic resonance imaging (MRI) showed a well-demarcated contrast-enhancing lesion located in the left upper precentral gyrus and the posterior superior frontal gyrus (Figure 1A–F), associated with an anterior vascular abnormality, highly
Discussion
In Borden type III dAVF, the pathologic connection between arteries and veins can be associated with venous hypertension, congestion, and infarction in the draining area of the affected vein.1, 2 This can cause disruption of the blood-brain barrier, leading to contrast-enhancing lesions on brain imaging.3 Borden Type III dAVF are mostly located in the spine.1 Here, dAVF associated with myelopathy and concomitant focal contrast enhancement have been described previously.4, 5, 6 The literature
References (9)
- et al.
Venous congestive myelopathy: a mimic of neoplasia
Mod Pathol
(2005) - et al.
Case of the season: dural arteriovenous fistula mimicking a bithalamic neoplasm or viral encephalitis
Semin Roentgenol
(2014) - et al.
High-grade dural arteriovenous fistula simulating a bilateral thalamic neoplasm
Clin Neurol Neurosurg
(2009) - et al.
A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment
J Neurosurg
(1995)
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Dural arteriovenous fistulas misdiagnosed as intracranial neoplasms: illustrative case
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Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.