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Case report
Rupture of a de novo dural AV fistula following adult cerebral AVM resection
  1. Evan M Luther1,
  2. Fatima Chagani2,
  3. Hunter King3 and
  4. Robert Starke1
  1. 1Neurological Surgery, University of Miami School of Medicine, Miami, Florida, USA
  2. 2Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  3. 3Neurological Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Evan M Luther; evan.luther{at}jhsmiami.org

Abstract

Acquired unruptured dural arteriovenous fistulas (DAVFs) have been described; however, ruptured de novo DAVFs remain exceedingly rare. We describe the case of a man in his 40s who presented with a recurrent intraparenchymal haemorrhage several years after angiographic cure of an intracranial arteriovenous malformation (AVM). Repeat angiography identified a new Cognard type IV DAVF anterior to the prior craniotomy. He underwent preoperative embolisation followed by craniotomy to completely obliterate the fistulous point. This case illustrates the need for close monitoring of AVM patients, even after complete obliteration, as local recrudescence of arteriovenous shunting can occur even in adulthood.

  • neurological injury
  • neuroimaging
  • stroke
  • interventional radiology
  • neurosurgery

https://doi.org/10.1136/bcr-2021-246758

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    Footnotes

    • Twitter @evanluthermd

    • Contributors EML data collection and manuscript writing. FC data collection and manuscript writing. HK data collection and manuscript writing. RS data collection and manuscript revisions.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.