Synchronous chronic middle cerebral artery occlusion and ipsilateral dural arteriovenous fistula |
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Authors: | Cooke Daniel L Johnson Guy Levitt Michael R Lewis David H Sekhar Laligam N Ghodke Basavaraj |
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Affiliation: | Department of Radiology, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA. dcooke@uw.edu |
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Abstract: | Dural arteriovenous fistulas (dAVFs) are a complex family of vascular malformations. Most series discuss features in isolation of other vascular pathologies, despite evidence that dAVFs may arise in a setting of elevated angiogenic growth factors related to regional hypoxia. We describe a 72-year-old man with ischemic symptoms secondary to middle cerebral artery stenosis and an incidental ipsilateral Borden I dAVF. Balloon-occlusion single photon emission computed tomography demonstrated reversible ischemia within the basal ganglia consistent with fistula-related "steal" phenomenon. This case supports the hypothesis that dAVFs may arise secondary to angiogenic growth factors related to regional tissue hypoxia. |
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