Abstract
We describe 5 cases of non-sinus type parasagittal dural arteriovenous fistulas (d-AVF) that had shunts that were drained exclusively by cortical veins without any sinus interposition. Between August 2009 and August 2014, we treated 5 cases of non-sinus type parasagittal d-AVF (4 men and 1 woman; mean age, 64.8 years). All cases were classified as Cognard type IV. Two cases presented with intracerebral hemorrhage, whereas the condition was identified incidentally in 3 cases. All patients underwent radical treatment, including transarterial embolization (TAE) alone in 1 case, surgical interruption of the draining vein in 2 cases, and TAE and surgical interruption of the draining vein in 2 cases, without any complications. During surgery in 4 cases, it was found that the draining vein and shunt point were attached to the depths of the falx cerebri, which was most likely related to the falcine venous plexus. This finding appears to be a notable feature of non-sinus type parasagittal d-AVF. Hence, non-sinus type parasagittal d-AVF should be considered as a separate clinical entity from the general superior sagittal sinus d-AVF.
