Abstract
Two cases of dural arteriovenous fistula (AVF) with sinus occlusion in the superior sagittal sinus are reported. Case 1 was a 47-year-old male, who was admitted because of several episodes of convulsions, followed by a progressive motor weakness in the right lower limb. He had an old history of a severe head injury. Case 2 was a 52-year-old male, who was admitted because of a sudden speech disturbance and left hemiparesis. He never experienced any head injury. Cerebral angiogram taken 2.5 years before showed no definite evidence of dural AVF except for occlusion of the superior sagittal sinus. Sequential computed tomography scans revealed hemorrhagic infarctions of moderate sizes in the bilateral frontal lobes, one of which was followed by a massive hemorrhagic infarction.
Clinical features of dural AVF in this region were characterized by convulsions and motor weakness in addition to bruit and headache, which seemed to depend on the location and blood flow. It was confirmed that the dural AVF in this area are acquired lesions evolving from the organization and revascularization of a previously thrombosed sinus. Every attempt should be made to excise the malformation, including the affected dural sinus, as completely as possible in the initial procedure.
