title: Dural arteriovenous fistula at the anterior clinoid process draining directly into the superficial middle cerebral vein.
abstract: A 76-year-old man presented with subarachnoid hemorrhage. Selective angiography revealed a dural arteriovenous fistula (DAVF) at the right anterior clinoid process, draining into the superficial middle cerebral vein in a retrograde fashion. Two internal carotid artery aneurysms were also demonstrated at the origin of the posterior communicating artery and the anterior choroidal artery on the same side. The patient underwent craniotomy, and all lesions were treated simultaneously. Rupture of the anterior choroidal artery aneurysm was confirmed. DAVF draining directly into the superficial middle cerebral vein is extremely rare. The precise location of the shunt, the anatomical features, and venous drainage must be evaluated to consider treatment.
authors.affiliation: Department of Neurosurgery, Hokkaido Medical Center, Sapporo, Hokkaido, Japan. s-ushi@hok-mc.hosp.go.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ushikoshi
authors.forename: Toshimi
authors.initials: T
authors.lastname: Honma
authors.forename: Kazuki
authors.initials: K
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasuda
authors.forename: Minoru
authors.initials: M
authors.lastname: Ajiki
mesh_terms: D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D002550:Cerebral Veins / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology; D006801:Humans; D008297:Male