[A case of dural arteriovenous malformation on the convexity adjacent to the superior sagittal sinus]

Abstract

A case of dural arteriovenous malformation (DAVM) on the convexity adjacent to the superior sagittal sinus (SSS) was reported. A 55-year-old female was admitted to our hospital complaining of severe headache and intracranial bruit. CT scan revealed an osteolytic lesion at the right frontal bone adjacent to the SSS, and MRI showed a flow void area at the same site. Cerebral angiography detected DAVM which was fed by bilateral superficial temporal arteries and plenty of meningeal branches of the middle meningeal artery. It was drained by cortical veins to the SSS. Endovascular surgery was tried for this lesion, but it failed. After the surgical excision of DAVM, the above symptoms disappeared with no complications. The 14 cases reported in the literature were examined to characterize DAVM at this site. Average age was 47 with no age distribution. 43% of the cases had intracranial hemorrhage, subarachnoid hemorrhage (2), intracranial hemorrhage (2), intraventricular hemorrhage (1), and subdural hematoma (1). The DAVM arises most frequently at the middle third of the SSS and tends to extend to the posterior third. The symptom most frequently seen is headache, but we ought to pay attention to the possibility of progressive dementia. As for therapy, direct surgical excision is sometimes necessary if intravascular embolization ends in failure or incomplete cure.