[Anterior ethmoidal dural fistulae. 3 new cases]

Area of Science:

• Neurosurgery
• Neuroradiology
• Vascular Neurology

Background:

• Dural arteriovenous fistulae (dAVFs) are abnormal connections between dural arteries and veins.
• Anterior ethmoidal dural fistulae are rare, particularly those presenting as spontaneous rupture.

Observation:

• Three new cases of anterior ethmoidal dural fistulae are presented.
• Two cases involved both dural and pial fistulae, while one was a pure pial fistula.
• All presented with spontaneous rupture.

Findings:

• Computed tomography (CT) demonstrated unilateral frontopolar hematoma in all cases.
• Angiographic assessment, including internal and external carotid artery evaluation, is crucial.
• Carotid angiography precisely defines the fistula and guides therapeutic strategies.

Implications:

• Early identification of anterior ethmoidal dural fistulae is critical for preventing complications.
• Multimodal imaging, including CT and angiography, is essential for diagnosis and management.
• Surgical intervention is the primary treatment modality for these complex vascular lesions.