Dural arteriovenous fistula disguised as cerebral venous sinus thrombosis

J Zhejiang Univ Sci B. 2017;18(8):733-736. doi: 10.1631/jzus.B1600499.

Abstract

Dural arteriovenous fistulas (DAVFs) are direct communications between the intracranial arterial and venous systems without an intervening nidus. Clinicians sometimes fail to give a correct diagnosis of DAVF. Given the similarity of their clinical and magnetic resonance imaging (MRI) manifestations, diagnostic confusion may arise between DAVF and cerebral venous sinus thrombosis (CVST) (Simon et al., 2009). The clinical management of DAVFs differs from that of CVST (Ma et al., 2015; Yang et al., 2015). Anticoagulation therapy is restricted in some cases of DAVFs, especially when they are associated with retrograde venous flow, due to the increased risk of hemorrhage. Here we present a case of a DAVF patient who had been initially misdiagnosed as CVST. We summarize the reasons for misdiagnosis and give some recommendations to address this problem.

Keywords: Dural arteriovenous fistula; Cerebral sinus thrombosis; Susceptibility-weighted MRI; Digital subtraction angiography.