A Case of Intracranial Cavernous Malformation Associated with Transverse-sigmoid Sinus Dural Arteriovenous Fistula

We report a rare case of intracranial cavernous malformation (CM) associated with transverse-sigmoid sinus dural arteriovenous fistula (T-SS DAVF). A 49-year old woman was admitted to our hospital with left motor weakness and seizure. Head computed tomography showed a mixed density mass lesion suggestive of CM in the right frontal lobe. She previously underwent head magnetic resonance imaging scans in another hospital, and no abnormalities were detected. De novo or radiographically occult CM was suspected. Cerebral angiography revealed right T-SS DAVF. The shunt flow disturbed normal venous return via the superior sagittal sinus and drained into the sphenoparietal sinus and superficial temporal vein. In order to normalize intracranial venous circulation, endovascular treatment of DAVF was performed first. The CM was removed following craniotomy. Although the relationship between CM and DAVF remains unclear, hemodynamic change caused by DAVF might affect de novo formation or growth of CM.

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