Dural arteriovenous fistula caused by sinus thrombosis--case report

A 58-year-old male with a history of idiopathic sinus thrombosis presented with gradual onset of gait disturbance, dementia, and involuntary movement in the upper extremities. Cerebral angiography demonstrated a dural arteriovenous fistula fed by a falx cerebelli branch originating from the left vertebral artery and draining into the inferior vermian vein, the straight sinus, a cortical vein lying on the inferolateral surface of the left cerebellar hemisphere, the ipsilateral superior petrosal sinus, the sigmoid sinus, and the internal jugular vein. Endovascular embolization under fluoroscopic control resulted in complete disappearance of the involuntary movement. Sinus thrombosis may result in development of dural arteriovenous fistula which can cause life-threatening complications, so aggressive therapy should be considered.