Acta Scientific Medical Sciences (ISSN: 2582-0931)

Case Report Volume 4 Issue 9

Dural Arteriovenous Fistula Presenting with Exophthalmos, Hemiparesis and Seizures: Resolution after Endovascular Treatment - Case Report

Aminur Rahman1*, Sirintara Pongpech2, Pakorn Jiarakongmun2, Ekachat Chanthanaphak2, Wittawat Takong2, Kittiphop Somboonnithiphol2, Thanaboon Worakijthamrongchai2 and Firoz Ahmed Quraishi3

1Department of Neurology, Sir Salimullah Medical College, Bangladesh
2The Division of Interventional Neuroradiology, Department of Radiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Thailand
3Department of Neurology, Anwar Khan Modern Medical College, Bangladesh

*Corresponding Author: Aminur Rahman, Department of Neurology, Sir Salimullah Medical College, Bangladesh.

Received: July 12, 2020; Published: August 26, 2020

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Abstract

A concomitant focal seizure with left hemipaeresis and exophthalmos in the context of an aggressive cavernous dural arteriovenous fistula (dAVF) is a variable neurological presentation. Here, we report a 73 years old female who presented with a 5-months history of progressive painless exophthalmos with conjunctival chemosis of right eye without any visual impairment. But now she had admitted to the hospital due to new onset of focal seizures with mild left hemipaeresis. Emergency MDCT scan brain showed suspected small malignant dural ateriovenous fistula of right sphenoparietal sinus with cerebral venous congestion and tiny hemorrhagic venous infarction at right operculum and right exophthalmos. Cerebral angiography demonstrated right cavernous dAVF fed by branches from the right ascending pharyngeal artery and right middle meningeal artery, right accessory meningeal artery, bilateral arteries of foramen rotendum, dural branch of left vertebral artery with drainage to the right superior ophthalmic vein, right sphenoparietal sinus and right frontal cortical vein which was consistent with Cognard Type IIb dAVF. Successful transvenous embolization of the right cavernous via the right inferior petrosal sinus was done by using fibre coils and NBCA. Post- embolization control angiogram showed complete obliteration of right cavernous dAVF feeding vessels. Subsequent clinical follow up revealed that she had dramatic improvement of proptosis, chemosis and neurological symptoms along with cessation of seizures.

Keywords: Dural Arteriovenous Fistula; Exophthalmos; Hemipaeresis; Seizures; Endovascular Treatment

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References

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Citation

Citation: Aminur Rahman, et al. “Dural Arteriovenous Fistula Presenting with Exophthalmos, Hemiparesis and Seizures: Resolution after Endovascular Treatment - Case Report". Acta Scientific Medical Sciences 4.9 (2020): 74-79.




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