title: A case of falcine sinus dural arteriovenous fistula.
abstract: BACKGROUND
  The falcine sinus is an embryonic vessel that connects the superior and inferior sagittal sinuses and mostly closes after birth. Although some cases of persistent falcine sinus have been reported, dural arteriovenous fistula (dAVF) associated with the falcine sinus has not previously been reported.
  
  
  METHODS
  A 60-year-old man presented with asymptomatic dAVFs on digital subtraction angiography. The dAVFs were fed mainly by the cortical branch of the left anterior cerebral artery and drained into the falcine sinus. Intraoperatively, all veins draining in a retrograde manner into cortical veins were obstructed. However, cortical venous reflux did not disappear before removal of the falx cerebri, including the falcine sinus and inferior sagittal sinus. In this case, we considered falcine sinus dAVF as equivalent to olfactory groove dAVF because the medial olfactory artery, in its role as a common feeding artery in olfactory groove dAVF, is a rudiment of the anterior cerebral artery as the main feeding artery in this case. Intraoperative findings and the surgical specimen revealed a small vessel network in the falx cerebri communicating with the falcine and inferior sagittal sinuses, which was considered to represent a falcine venous plexus, not a vessel anomaly.
  
  
  CONCLUSIONS
  Extensive removal of the falx cerebri including the falcine sinus or complete endovascular obliteration of the whole falcine sinus as early as possible represents an important strategy in the surgical treatment of falcine sinus dAVF.
authors: Department of Neurosurgery, Research Institute for Brain and Blood Vessels, Akita, Japan. shotaroh@akita-noken.jp
authors: Shotaro
authors: S
authors: Yoshioka
authors: Junta
authors: J
authors: Moroi
authors: Shinya
authors: S
authors: Kobayashi
authors: Nobuharu
authors: N
authors: Furuya
authors: Tatsuya
authors: T
authors: Ishikawa
mesh_terms: D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000473:pathology*; D004388:Dura Mater / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged