From Diagnosis to Complication: A Detailed Case Analysis on the Journey of Managing Medial Tentorial Dural Arteriovenous Fistula
Year: 2024
Type: article
Study design: Case Report
Abstract: Tentorial dural arteriovenous fistulas (DAVFs) are rare but highly dangerous vascular anomalies, constituting a small percentage of all intracranial DAVFs. Despite their infrequency, these lesions display aggressive characteristics, frequently leading to hemorrhage or neurological deficits due to their retrograde drainage into leptomeningeal veins, thus classifying them as Borden type III lesions. This case presents a middle-aged man who suffered cerebellar and subarachnoid hemorrhages resulting from a medial tentorial DAVF. Initial imaging revealed a high-flow vascular lesion, which was subsequently confirmed through angiography. Endovascular embolization targeted the right middle meningeal artery, showing initial improvement. However, the patient experienced a notable decline two days later, attributed to residual or recurrent fistulas, venous hypertension, and cerebral edema. Effective management of tentorial DAVFs necessitates a multidisciplinary approach, combining endovascular, surgical, and occasionally radiosurgical techniques. Continuous monitoring is essential for early detection and management of complications. This case underscores the critical need for a comprehensive strategy to manage the high risks associated with these vascular anomalies and to prevent potentially life-threatening outcomes.
Source: Cureus
DOI: 10.7759/cureus.70240
Author: Alali Meshari
Institution: Majmaah University
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4402875105