A dural arteriovenous fistula of the tentorium successfully treated by intravascular embolization

BACKGROUND Dural arteriovenous fistulas of the tentorium are rare lesions t hat often present with intracranial hemorrhage. Definitive treatment is the refore necessary, but transarterial embolization has rarely been curative. CASE DESCRIPTION A 59-year-old man presenting with sudden onset of severe h eadache had subarachnoid hemorrhage demonstrated by computed tomography. Le ft carotid angiography showed a tentorial dural arteriovenous fistula fed b y a tentorial branch from the internal carotid artery and by a middle menin geal artery; the fistula drained to the marginal sinus via a dilated varico sity. Transarterial embolization successfully obliterated the fistula, and the patient was discharged with no neurologic deficit. CONCLUSION This tentorial fistula, that showed extremely rare angiographic features, particularly venous drainage, was embolized successfully. The lit erature concerning tentorial dural arteriovenous fistulas is discussed in t erms of effective therapeutic choice. (C) 1999 by Elsevier Science Inc.