DURAL ARTERIOVENOUS-MALFORMATIONS AT THE BASE OF THE ANTERIOR CRANIALFOSSA - REPORT OF 9 CASES

Nine men with dural arteriovenous malformations (DAVM) at the base of the anterior cranial fossa are described. Four patients had intracereb ral haemorrhage and four had seizures, associated with haemorrhage in two. In three cases the fistula was an incidental finding. In five cas es the diagnosis could be made before angiography, on the basis of CT findings. Angiographically, venous drainage was always seen into ascen ding cortical veins. Five cases demonstrated drainage via the olfactor y vein into the basal vein of Rosenthal; in four this way was the prin cipal route of drainage. Five patients underwent surgery, the therapy of choice. One fistula closed spontaneously after angiography. Two pat ients refused treatment and one was not treated because of his poor ge neral condition. Because arterial supply was usually bilateral, from s mall branches of the ophthalmic artery, embolisation seemed to be more dangerous. Compared to dural fistulae in other locations the DAVM of the anterior cranial fossa have a higher risk of complications and sho uld be treated even if asymptomatic at the time of diagnosis.