Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Subcortical calcification on CT in Borden type III intracranial dural arteriovenous fistula

Kazuyuki Saito, M.D., Ph.D.1), Taro Hino, M.D., Ph.D.2), Satoshi Fujita, M.D., Ph.D.3), Morito Hayashi, M.D., Ph.D.3), Takayuki Kubodera, M.D., Ph.D.1) and Yoshiaki Wada, M.D., Ph.D.1)2)

1)Department of Neurology, Nissan Tamagawa Hospital
2)Nissan Tamagawa Hospital Rehabilitation Center
3)Department of Neurosurgery, Toho University Ohashi Medical Center

We herein report a 67-year-old female who presented with progressive dementia and disturbance of consciousness. Brain CT showed multiple subcortical calcifications with edema. Enhanced CT showed multiple abnormal vessels in the left hemisphere. Electroencephalography indicated diffuse spike and slow wave complex, so non-convulsive status epilepticus was diagnosed. Cerebral angiography revealed several feeder arteries with retrograde leptomeningeal venous drainage. We diagnosed her with Borden type III cerebral dural arteriovenous fistulas. Trans-arterial embolization with n-butyl-2-cyanoacrylate was performed, and she has experienced no epileptic attacks for at least ten months. Calcification changes are sometimes seen in Borden type II dural arteriovenous fistulas but not in aggressive types, such as Borden type III. It is important to suspect dural arteriovenous fistulas when we encounter patients with progressive dementia or/and epilepsy with cerebral calcification lesions, as this may be a treatable disease condition.
Full Text of this Article in Japanese PDF (997K)

(CLINICA NEUROL, 59: 93|97, 2019)
key words: subcortical calcification, dural arteriovenous fistula, Borden type III, epilepsy

(Received: 4-Jul-18)