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Case Reports
. 2014 Apr 30;6(1):122-5.
doi: 10.1159/000362116. eCollection 2014 Jan.

A case of dural arteriovenous fistula presenting as acute subdural hematoma

Atsushi Saito  1 , Tomohiro Kawaguchi  1 , Tatsuya Sasaki  1 , Michiharu Nishijima  1
Affiliations
Case Reports

A case of dural arteriovenous fistula presenting as acute subdural hematoma

Atsushi Saito et al. Case Rep Neurol. .

Abstract

Dural arteriovenous fistula (AVF) presenting with subdural hematoma is relatively rare. We report a case of dural AVF presenting as acute subdural hematoma (ASDH) and provide a review of the literature. A 56-year-old man presented with disturbance of consciousness. Computed tomography demonstrated a right ASDH and a small right occipital subcortical hematoma. Cerebral angiography showed a dural AVF on the occipital convexity draining into the cortical veins. Emergent endovascular embolization was immediately performed and the shunt flow disappeared. Hematoma removal and external decompression were safely conducted. Combined therapy successfully recovered the patient's consciousness level. This rare case of dural AVF presenting with ASDH was treated with combined treatments of endovascular and open surgery.

Keywords: Acute subdural hematoma; Dural arteriovenous fistula; Intracerebral hematoma.

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Figures

Fig. 1
Fig. 1
a Computed tomography revealing a right ASDH of 1.5 cm in diameter and a 15-ml oval subcortical hematoma in the right occipital lobe associated with slight perifocal edema. The midline is slightly shifted to the left. b Right external carotid angiography demonstrating a dural AVF located in the right occipital convexity associated with venous pouches and cortical reflux and classified as type IV on the Cognard classification. Left = anteroposterior view; right = lateral view.
See this image and copyright information in PMC

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