title: Dural Arteriovenous Fistula Mimicking a Supratentorial Tumor.
abstract: BACKGROUND
  The pathophysiology of dural arteriovenous fistulas (dAVF) is not fully understood. Retrograde venous flow can lead to venous congestion and disruption of the blood-brain barrier, resulting in diffuse contrast enhancement.
  
  
  METHODS
  We present the case of a patient with a supratentorial dAVF associated with a solid, tumor-appearing, corticosubcortical contrast-enhancing lesion. Surgical occlusion of the dAVF was followed by complete regression of the contrast-enhancing lesion. Histologic analysis of the lesion showed normal brain tissue.
  
  
  CONCLUSIONS
  This case report highlights how venous congestion is an important differential diagnosis in contrast-enhancing lesions associated with dAVF and how it should be taken in consideration to avoid radiologic misdiagnoses and unnecessary treatment.
authors.affiliation: Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland. Electronic address: johannes.goldberg@insel.ch.
authors.forename: Johannes
authors.initials: J
authors.lastname: Goldberg
authors.affiliation: Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Beck
authors.affiliation: Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Bervini
mesh_terms: D001812:Blood-Brain Barrier / Q000503:physiopathology / Q000601:surgery*; D001921:Brain / Q000000981:diagnostic imaging / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D017023:Coronary Angiography; D005260:Female; D005682:Gadolinium / Q000493:pharmacokinetics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015173:Supratentorial Neoplasms / Q000503:physiopathology*
chemical_list: D005682:Gadolinium
keywords: Arteriovenous fistula; Brain; Contrast enhancement; Dural arteriovenous fistula; Venous congestion