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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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An Elderly Patient With Status Epilepticus Caused by a Dural Arteriovenous Fistula
Takuya Saito1, Hiroshi Fukaya1, Shunsuke Omodaka2
1Department of Stroke Neurology, Kohnan Hospital, Sendai, JPN.
Abstract:
Dural arteriovenous fistulas (DAVFs) are a rare cause of epilepsy. Therefore, they can be misdiagnosed or overlooked. We report a case of an 84-year-old female with Alzheimer's disease who developed status epilepticus as the initial manifestation of the left transverse sinus DAVF. On admission, symptomatic epilepsy secondary to Alzheimer's disease was suspected, and medical therapy was started; however, clinical improvement was limited. Magnetic resonance imaging and magnetic resonance angiography findings provided clues for the diagnosis of the left transverse sinus DAVF. Endovascular treatment led to improvement in behavioral symptoms and electroencephalography findings with no seizure recurrence. One month later, she returned to her baseline condition. This case highlights the importance of including DAVF in the differential diagnosis of seizures in older adults and of recognizing that invasive endovascular therapy may offer a curative option.
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