Abstract
We reported a case of dural arteriovenous fistula of the transverse-sigmoid sinus with pure leptomeningeal drainage. A 51-year-old man presented with generalaized convulsions. Neurological examination was normal. CT scans demonstrated a small hemorrhage in the left temporal lobe. Left external carotid angiograms showed dural arteriovenous fistula of the transverse-sigmoid sinus fed by occipital, posterior auricular, middle meningeal arteries. The draining vein was vein of Labbe. Left internal carotid angiograms demonstrated venous congestion in the left temporal lobe. Transverse and sigmoid sinuses were patent. ^123I-IMP SPECT revealed a low perfusion area in the left temporal region. Dynamic CT scans revealed venous congestion in the left temporal region. We considered that the venous congestion had caused the hemorrhage in the left temporal lobe. Initially, we embolised the dural arteriovenous fistula using a transarterial approach with HEMA-MMA. However, recanalization was detected after a short period. Therefore, we interrupted the draining vein of the dural arteriovenous fistula. Angiographic cure was obtained and the postoperative course was uneventful. We discussed the clinical features, the hemodynamic findings and the management of this case.
