title: Tentorial dural arteriovenous fistula presenting as episodic weakness mimicking periodic paralysis.
abstract: We report a rare case of episodic limb weakness caused by a tentorial dural arteriovenous fistula (DAVF) draining into the perimesencephalic veins. A middle-aged man presented with episodes of transient quadriparesis preceded by recurrent vomiting. The patient was initially suspected of having periodic paralysis but, due to the presence of recurrent vomiting and brisk reflexes, MR imaging of the brain was performed which revealed marked T2 hyperintensity of the brainstem and cervical cord along with multiple prominent flow voids. Cerebral angiography showed a Borden type 3 DAVF at the left tentorial margin which was draining into the perimesencepahlic and perimedullary veins and refluxing into the cervical epidural veins. The patient made a remarkable recovery after surgical interruption of the fistula.
authors.affiliation: Institute of Neurosciences, Medanta- the Medicity, Gurgaon, Haryana, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Singh
authors.forename: Arun
authors.initials: A
authors.lastname: Garg
authors.forename: Aditya
authors.initials: A
authors.lastname: Gupta
authors.forename: Gaurav
authors.initials: G
authors.lastname: Goel
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gupta
authors.forename: Atmaram
authors.initials: A
authors.lastname: Bansal
mesh_terms: D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000628:therapy*; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology*; D010245:Paralyses, Familial Periodic / Q000175:diagnosis*