title: Synchronous chronic middle cerebral artery occlusion and ipsilateral dural arteriovenous fistula.
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.
authors.affiliation: Department of Radiology, Harborview Medical Center, University of Washington, Seattle, WA 98195, USA. dcooke@uw.edu
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Cooke
authors.forename: Guy
authors.initials: G
authors.lastname: Johnson
authors.forename: Michael R
authors.initials: MR
authors.lastname: Levitt
authors.forename: David H
authors.initials: DH
authors.lastname: Lewis
authors.forename: Laligam N
authors.initials: LN
authors.lastname: Sekhar
authors.forename: Basavaraj
authors.initials: B
authors.lastname: Ghodke
mesh_terms: D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D015899:Tomography, Emission-Computed, Single-Photon