Abstract
A 69-year-old female presented with a dural arteriovenous malformation (AVM) in the cavernous sinus, which manifested by subarachnoid hemorrhage. On angiography a small vascular malformation arising from the meningohypophyseal artery was found. The draining vein from the cavernous sinus wound up to the right sylvian fissure and drained further into the vein of Labbe. There was no opacification of the cavernous sinus. A computed tomography scan revealed high-density areas in both the right sylvian fissure and the frontal lobe. On day 7 after the ictus, right abducens palsy and chemosis appeared and gradually progressed during the next 7 days, along with symptoms of increased intracranial pressure. After diagnosis of spontaneous carotid-cavernous fistula (CCF), conservative treatment was continued. Eye signs of CCF completely subsided 1 month after onset, and carotid angiography demonstrated spontaneous closure of the dural AVM. Possible mechanisms of the development of the CCF and spontaneous closure of the dural AVM is discussed.
