Spontaneous Thrombosis of Dural Arteriovenous Malformation: A Case Report

Dural arteriovenous malformation (DAVM) is relatively rare and defined as abnormal connections or shunts between the arterial and the venous side of vascular tree located within the dura mater. Spontaneous closures of DAVM are rare and have been scarcely reported. This case report will describe the neuroimaging findings and classification of DAVM. A 50 year old lady presented with headache. Neuroimaging showed prominent serpinginous flow-void structures, cerebral angiogram confirmed the presence of DAVM at the occipital region. She had defaulted treatment and follow up for 3 years. On second admission, she had a cerebral angiogram which showed normal findings with no evidence of fistulas or malformation. She was discharged well. Causes of spontaneous closure of DAVM are discussed.

“Heartbeat in the head”–An atypical presentation of Dural Arteriovenous Malformation

Pulsatile tinnitus is an uncommon presenting symptom and is perceived to be repetitively synchronous with the patient’s heartbeat. Prompt recognition of this rare symptom and subsequent early identification of the underlying etiology is essential for timely management to prevent potentially major complications. Here we highlight a case of a middle-aged female who presented with symptom of ‘heartbeat in the head’ and was later found to have left dural arteriovenous fistula.

Endovascular treatment of a spinal dural arteriovenous malformation (DAVF)

We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine.The video can be found here: http://youtu.be/SDYNIGNQIW8.