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Updated: Jun 12, 2025
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Dural arteriovenous fistula mimicking a stroke: A misdiagnosis of two months
Megan Finneran1, John Squire2, Ajeet Gordhan3
1Department of Neurosurgery, Carle BroMenn Medical Center, Normal, IL, USA.
Abstract:
We present a case of a 70-year-old male who presented with left-sided weakness and dysarthria. Cranial imaging was suggestive of a cerebellar infarct and the patient was treated with aspirin and clopidogrel. Two months later a fall prompted further cranial imaging, which was concerning for an intracranial mass with vasogenic edema. Computed tomography angiogram (CTA) was negative for vascular lesion. Ultimately, a DSA revealed a Borden III dAVF between the right occipital artery and the posterior cerebellar vein that was treated with endovascular embolization.
Insights
A 70-year-old male with stroke symptoms was diagnosed with a rare dural arteriovenous fistula (dAVF). Endovascular embolization successfully treated this complex vascular lesion.
Area of Science:
- Neurology
- Neuroradiology
- Vascular Surgery
Background:
- Cerebellar infarcts can present with focal neurological deficits.
- Intracranial masses can mimic other neurological conditions.
- Dural arteriovenous fistulas (dAVFs) are abnormal connections between dura mater arteries and veins.
Observation:
- A 70-year-old male presented with left-sided weakness and dysarthria, initially suspected as a cerebellar infarct.
- Follow-up imaging after a fall revealed an intracranial mass with vasogenic edema.
- Computed tomography angiogram (CTA) did not identify a vascular lesion.
Findings:
- Digital subtraction angiography (DSA) diagnosed a Borden III dAVF involving the right occipital artery and posterior cerebellar vein.
- The patient was treated with endovascular embolization for the dAVF.
Implications:
- This case highlights the importance of considering dAVFs in the differential diagnosis of intracranial masses and stroke-like symptoms.
- Endovascular embolization is an effective treatment for complex dAVFs.
- Accurate diagnosis and timely intervention are crucial for managing dAVFs and preventing complications.
