OJMN  Vol.5 No.2 , April 2015
Undiagnosed Anterior Cranial Fossa Dural Arteriovenous Fistula with Intracranial Hematoma: Case Report and Review of the Literature about Its Natural History
Abstract: Dural arteriovenous fistulas (dAVFs) of an anterior cranial fossa are rare. Because of the high risk of intracranial hemorrhage and relatively easy access for direct surgery, aggressive treatment has been recommended. The natural history of anterior cranial fossa dAVFs (ACF dAVFs) is unclear in spite of many reports for the natural history of general dAVFs. To treat ACF dAVFs, direct surgery has traditionally been performed and endovascular surgery has recently been introduced. A 74-year-old man was transferred with severe consciousness disturbance and presented with devastating intracerebral hemorrhage on the CT scan. Digital subtraction angiography revealed the ACF dAVFs with a large venous pouch. The patient received direct surgery, nevertheless he became vegetative state. Later on, a smaller venous pouch was recognized on the CT scan when he had suffered from the thalamic hemorrhage sixteen months before. There are twelve cases including our case which was treated for a certain period and documented in detail. Eleven of twelve cases were asymptomatic. Three of the six cases with a venous pouch had some events possibly related to the disease, though none of the six cases without a venous pouch had any events during observation. In conclusion, an ACF dAVF with a venous pouch should be treated by direct surgery or endovascular surgery even if it is incidentally found. By contrast, careful observation might be a possible therapeutic option for an ACF dAVF without a venous pouch if there is mild reflux flow.
Cite this paper: Yamaguchi, T. , Miyata, S. , Mashiko, T. and Watanabe, E. (2015) Undiagnosed Anterior Cranial Fossa Dural Arteriovenous Fistula with Intracranial Hematoma: Case Report and Review of the Literature about Its Natural History. Open Journal of Modern Neurosurgery, 5, 64-69. doi: 10.4236/ojmn.2015.52011.

[1]   Houser, O.W., Baker Jr., H.L., Rhoton Jr., A.L. and Okazaki, H. (1972) Intracranial Dural Arteriovenous Malformations. Radiology, 105, 55-64.

[2]   Ohta, T. and Kajikawa, H. (1978) Dural Arteriovenous Malformation (Author’s Transl). Neurologia Medico-Chirurgica (Tokyo), 18, 439-472 (in Japanese).

[3]   Newton, T.H., Weidner, W. and Greitz, T. (1968) Dural Arteriovenous Malformation in the Posterior Fossa. Radiology, 90, 27-35.

[4]   Malik, G.M., Pearce, J.E., Ausman, J.I. and Mehta, B. (1984) Dural Arteriovenous Malformations and Intracranial Hemorrhage. Neurosurgery, 15, 332-339.

[5]   Lasjaunias, P., Manelfe, C. and Chiu, M. (1986) Angiographic Architecture of Intracranial Vascular Malformations and Fistulas—Pretherapeutic Aspects. Neurosurgical Review, 9, 253-263.

[6]   Lepoire, J., Montaut, J., Bouchot, M. and Laxenaire, M. (1963) Intrafrontal Arteriovenous Aneurysms Vascularized by the Anterior Ethmoidal Artery. Apropos of 3 Cases. Neuro-Chirurgie, 9, 159-166 (in French).

[7]   King, W.A. (1993) Anterior Fossa Dural Arteriovenous Malformation. In: Award, I.A. and Barrow, D.L., Eds., Dural Arteriovenous Malformations, American Association of Neurological Surgeons, Park Ridge, 105-106.

[8]   Gliemroth, J., Nowak, G. and Arnold, H. (1999) Dural Arteriovenous Malformation in the Anterior Cranial Fossa. Clinical Neurology Neurosurgery, 101, 37-43.

[9]   Halbach, V.V., Higashida, R.T., Hieshima, G.B., Charles, B.W., Stanley, L.B. and Christopher, F.D. (1990) Dural Arteriovenous Fistulas Supplied by Ethmoidal Arteries. Neurosurgery, 26, 816-823.

[10]   Kaplan, S.S., Ogilvy, C.S. and Crowell, R.M. (1994) Incidentally Discovered Arteriovenous Malformation of the Anterior Fossa Dura. British Journal of Neurosurgery, 8, 755-759.

[11]   Kikuchi, K. and Kowada, M. (1994) Anterior Fossa Dural Arteriovenous Malformation Supplied by Bilateral Ethmoidal Arteries. Surgical Neurology, 41, 56-64.

[12]   Yoshimoto, H., Yukawa, O., Aoyama, H., Maeda, H. and Uozumi, T. (1993) Intracerebral Arteriovenous Malformation Fed by the Anterior Ethmoidal Artery—Case Report. Neurologia Medico-Chirurgica (Tokyo), 33, 246-250.

[13]   Reul, J., Thron, A., Laborde, G. and Bruckmann, H. (1993) Dural Arteriovenous Malformations at the Base of the Anterior Cranial Fossa: Report of Nine Cases. Neuroradiology, 35, 388-393.

[14]   Deshmukh, V.R., Chang, S., Albuquerque, F.C., McDougall, C.G. and Spetzler, R.F. (2005) Bilateral Ethmoidal Dural Arteriovenous Fistulae: A Previously Unreported Entity: Case Report. Neurosurgery, 57, E809.

[15]   Nakagawa, K., Takasato, Y. and Ito, Y. (1994) A Case of Dural Arteriovenous Malformation in the Anterior Cranial Fossa Presenting with Intracranial Hemorrhage. Brain and Nerve, 46, 387-391.

[16]   Geibprasert, S., Pereira, V., Krings, T., Jiarakongmun, P., Toulgoat, F., Pongpech, S. and Lasjaunias, P. (2008) Dural Arteriovenous Shunts: A New Classification of Craniospinal Epidural Venous Anatomical Bases and Clinical Correlations. Stroke, 39, 2783-2794.

[17]   Awad, I.A., Little, J.R., Akarawi, W.P. and Ahl, J. (1990) Intracranial Dural Arteriovenous Malformations: Factors Predisposing to an Aggressive Neurological Course. Journal of Neurosurgery, 72, 839-850.

[18]   van Dijk, J.M., ter Brugge, K.G., Willinsky, R.A. and Wallace, M.C. (2002) Clinical Course of Cranial Dural Arteriovenous Fistulas with Long-Term Persistent Cortical Venous Reflux. Stroke, 33, 1233-1236.

[19]   Strom, R.G., Botros, J.A., Refai, D., Moran, C.J., Cross 3rd, D.T., Chicoine, M.R., Crubb Jr., R.L., Rich, K.M., Dacey Jr., R.G., Derdeyn, C.P. and Zipfel, G.J. (2009) Cranial Dural Arteriovenous Fistulae: Asymptomatic Cortical Venous Drainage Portends Less Aggressive Clinical Course. Neurosurgery, 64, 241-247, Discussion 247-248.

[20]   Jamous, M.A., Satoh, K., Satomi, J., Matsubara, S., Nakajima, N., Uno, M. and Nagahiro, S. (2004) Detection of Enlarged Cortical Vein by Magnetic Resonance Imaging Contributes to Early Diagnosis and Better Outcome for Patients with Anterior Cranial Fossa Dural Arteriovenous Fistula. Neurologia Medico-Chirurgica (Tokyo), 44, 516-520, Discussion 520-521.

[21]   Bitoh, S., Nakagawa, H., Arita, N. and Fujiwara, M. (1981) Dural Arteriovenous Malformation in the Anterior Fossa: Case Report. Neurologia Medico-Chirurgica (Tokyo), 21, 131-134.

[22]   Yamasaki, F., Hotta, T., Taniguchi, E., Eguchi, K., Hashizume, A., Kodama, Y. and Yuki, K. (1995) A Case of Dural Arteriovenous Malformation in the Anterior Fossa Associated with an Occlusion of the Unilateral Middle Cerebral Artery with Moyamoya Phenomenon. No Shinkei Geka, 23, 603-607.

[23]   Ishikawa, T., Houkin, K., Tokuda, K., Kawaguchi, S. and Kashiwaba, T. (1997) Development of Anterior Cranial Fossa Dural Arteriovenous Malformation Following Head Trauma: Case Report. Journal of Neurosurgery, 86, 291-293.

[24]   Im, S.H., Oh, C.W. and Han, D.H. (2004) Surgical Management of an Unruptured Dural Arteriovenous Fistula of the Anterior Cranial Fossa: Natural History for 7 Years. Surgical Neurology, 62, 72-75, Discussion 75.

[25]   Murakami, K., Matsumoto, K., Numagami, Y., Tomita, T. and Nishijma, M. (2005) A Case of Secondary Anterior Fossa Dural Arteriovenous Fistula Following Posterior Fossa Craniotomy. No Shinkei Geka, 33, 1101-1105.

[26]   Hashiguchi, A., Mimata, C., Ichimura, H., Morioka, M. and Kuratsu, J. (2007) Venous Aneurysm Development Associated with a Dural Arteriovenous Fistula of the Anterior Cranial Fossa with Devastating Hemorrhage—Case Report. Neurologia Medico-Chirurgica (Tokyo), 47, 70-73.

[27]   Tanei, T., Fukui, K., Wakabayashi, K., Mitsui, Y., Inoue, N. and Watanabe, M. (2008) Dural Arteriovenous Fistula in the Anterior Cranial Fossa: Four Case Reports. Neurologia Medico-Chirurgica (Tokyo), 48, 560-563.

[28]   Cognard, C., Gobin, Y.P., Pierot, L., Bailly, A.L., Houdart, E., Casasco, A., Chiras, J. and Merland, J.J. (1995) Cerebral Dural Arteriovenous Fistulas: Clinical and Angiographic Correlation with a Revised Classification of Venous Drainage. Radiology, 194, 671-680.

[29]   Defreyne, L., Vanlangenhove, P., Vandekerckhove, T., Deschrijver, I., Sieben, G., Klaes, R. and Kunnen, M. (2000) Transvenous Embolization of a Dural Arteriovenous Fistula of the Anterior Cranial Fossa: Preliminary Results. American Journal of Neuroradiology, 21, 761-765.

[30]   Agid, R., Terbrugge, K., Rodesch, G., Andersson, T. and Soderman, M. (2009) Management Strategies for Anterior Cranial Fossa (Ethmoidal) Dural Arteriovenous Fistulas with an Emphasis on Endovascular Treatment. Journal of Neurosurgery, 110, 79-84.

[31]   Lv, X., Li, Y. and Wu, Z. (2008) Endovascular Treatment of Anterior Cranial Fossa Dural Arteriovenous Fistula. Neuroradiology, 50, 433-437.

[32]   Li, C., Wu, Z., Yang, X., Li, Y., Jiang, C. and He, H. (2014) Transarterial Treatment with Onyx of Cognard Type IV Anterior Cranial Fossa Dural Arteriovenous Fistulas. Journal of Neurointerventional Surgery, 6, 115-120.