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Published on: August 11, 2015
Epistaxis caused by a dural AV-fistula at the cribriform plate
J Marc C van Dijk1, Astrid G W Korsten-Meijer, Aryan Mazuri
1Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Objectives/Hypothesis:
A dural arteriovenous fistula (DAVF) with cortical venous reflux (CVR) is a dangerous neurovascular entity. A DAVF at the cribriform plate is typically silent until its inevitable presentation with intracranial hemorrhage.
Case Summary:
A 67-year-old male presented with severe epistaxis. Following unsuccessful conventional measures and a surgical exploration, a catheter angiography showed a DAVF at the cribriform plate, with its nidus extending into the nasal cavity. The DAVF was treated via a small craniotomy.
Conclusion:
In case of atypical or unexplained nosebleeds, the possibility of a DAVF or other neurovascular pathology should be excluded by MRI/MRA or catheter angiography.
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