Cavernous Sinus Dural Arteriovenous Fistula with an Enhanced Lesion in the Brainstem Mimicking a Malignant Tumor

Related Experiment Video

Updated: Dec 21, 2025

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Kosuke Nambu¹, Kouichi Misaki¹, Akifumi Yoshikawa¹

¹Division of Neuroscience, Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Japan.

World Neurosurgery

|May 15, 2020

Abstract

Background:

Cavernous sinus (CS) dural arteriovenous fistula (dAVF) with an enhanced lesion in the brainstem is rare, and an enhanced lesion in the brainstem might be indicative of irreversibility.

Case Description:

A 77-year-old woman presented with double vision and ataxia. Magnetic resonance imaging showed a unilateral enhancement lesion in the pons, so a malignant brain tumor was suspected. A cerebral angiogram revealed CS-dAVF with retrograde leptomeningeal venous drainage (RLVD) to the brainstem. Transvenous embolization with selective coil embolization of RLVD was performed, and the symptoms and imaging improved dramatically.

Conclusions:

DAVFs with RLVD should be mentioned as a differential diagnosis of enhanced lesions in the brainstem. Transvenous embolization with selective coil embolization of RLVD was effective for the treatment of CS-dAVF, and a unilateral enhanced brainstem lesion may be reversible.

Keywords:

Brainstem enhanced lesion Cavernous sinus Dural arteriovenous fistula Retrograde leptomeningeal venous drainage Selective coil embolization Transvenous embolization

More Related Videos

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Published on: July 5, 2021

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Published on: July 5, 2011

Related Concept Videos

Veins of Head and Neck

Veins of Head and Neck

The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...

Anatomy of the Brain: Ventricles

Anatomy of the Brain: Ventricles

There are hollow fluid-filled cavities known as ventricles deep inside the human brain. There are two lateral ventricles, one in each cerebral hemisphere, and each has three different projections — the anterior, inferior, and posterior horns visible from the lateral side. A thin membrane called the septum pellucidum separates the two lateral ventricles. The slender third ventricle in the diencephalon is connected to each lateral ventricle via a channel called the interventricular foramen.

The Arch of Aorta

The Arch of Aorta

The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
Encircling the heart, the coronary arteries form a ring-like structure before...

Arteries of the Head and Neck

Arteries of the Head and Neck

The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...

Articles linked to this work by shared authors, journal, and citation graph.

Two-point Loop Suture Fixation May Reduce Catheter Displacement in Cisternal and External Ventricular Drains.

Neurologia medico-chirurgica·2026

Cholesterol granuloma of the sphenoid wing with long-term growth dynamics: illustrative case.

Journal of neurosurgery. Case lessons·2026

Meningioma enlargement associated with luteinizing hormone-releasing hormone agonist therapy: two cases and supporting in vitro evidence.

Brain tumor pathology·2026

Glioma Segmentation on Multicenter 2D-Based Magnetic Resonance Imaging Using Low-Rank Adaptation Tuning of a Foundation Model: An External Test Evaluation.

Journal of imaging informatics in medicine·2026

Working conditions, career barriers and perceived equity among neuro-oncology professionals: insights from the Japan society for neuro-oncology (JSNO) gender equality and diversity committee survey.

International journal of clinical oncology·2026

Elderly-Onset Moyamoya Disease Presenting with Hemichorea Associated with Basal Ganglia Hyperperfusion: Symptomatic Improvement after Revascularization Surgery.

Case reports in neurology·2026

See all related articles