抄録
Acute subdural hematoma (SDH) caused by dural arteriovenous fistula (DAVF) of the anterior cranial fossa is usually accompanied by intra-cerebral hemorrhage and/or subarachnoid hemorrhage, and pure SDH is relatively rare. We report a case of a 70-year-old male patient with an acute SDH caused by a ruptured DAVF of the anterior cranial fossa accompanied with a skull fracture, diagnosed by 3D CT angiography (3DCTA). Feeding arteries that branched from the bilateral anterior ethmoidal arteries followed dilated leptomeningeal veins with varix, which drained into the superior sagittal sinus. The patient underwent emergent evacuation of the SDH and resection of the DAVF, including the anterior frontal lobe. A histopathological examination showed a dilated vein with reactively thickening walls surrounded by small vessels in the leptomeninges on the cortex. We emphasize the utility of preoperative 3DCTA in the evacuation of acute SDH.
