Dural arteriovenous fistula with crista galli erosion in a patient with suspected sinusitis

Yuki Takaki, MD; Satoshi Tsutsumi, MD; Shinichiro Teramoto, MD; Senshu Nonaka, MD; Hidehiro Okura, MD; Takamoto Suzuki, MD; Hisato Ishii, MD

Radiology Case Reports (May 2021)

Dural arteriovenous fistula with crista galli erosion in a patient with suspected sinusitis

Yuki Takaki, MD,
Satoshi Tsutsumi, MD,
Shinichiro Teramoto, MD,
Senshu Nonaka, MD,
Hidehiro Okura, MD,
Takamoto Suzuki, MD,
Hisato Ishii, MD

Affiliations

Yuki Takaki, MD: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
Satoshi Tsutsumi, MD: Corresponding author.; Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
Shinichiro Teramoto, MD: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
Senshu Nonaka, MD: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
Hidehiro Okura, MD: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
Takamoto Suzuki, MD: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
Hisato Ishii, MD: Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan

Journal volume & issue: Vol. 16, no. 5
pp. 1028 – 1031

Abstract

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Dural arteriovenous fistula (dAVF) of the anterior cranial fossa is an aggressive entity with a high risk of intracranial hemorrhage. A 38-year-old woman presented to our institution with nasal obstruction and discharge. Computed tomography (CT) scans performed for suspected sinusitis revealed erosion of the crista galli predominantly on the left side. The frontal and ethmoidal sinuses adjacent to the crista galli were clear and did not communicate with the crista galli. Contrast computed tomography scans revealed ectatic vessels adjacent to the crista galli, coursing on the cortical surface. Cerebral angiography identified an anterior fossa dAVF supplied by the bilateral anterior and posterior ethmoidal arteries and drained by the dilated cortical veins. Based on these findings, we assumed that long-term compression by the pulsatile draining veins caused the erosion. The patient underwent successful microsurgical disconnection procedure of the dAVF with an uneventful postoperative course. We concluded that external erosion of the crista galli could be a sign of aggressive dAVF and requires careful examination.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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