Dural arteriovenous malformation associated with recurrent subdural haematoma and intracranial hypertension

An unusual case of intracranial hypertension and symptoms of a left parieto -occipital mass lesion due to a dural arteriovenous malformation (AVM) with a large and dilated draining vein is reported. The patient also had a hist ory of homolateral recurrent subdural haematoma, 11 years before. Subdural haematoma is rarely associated to a dural AVM. We suggest that the recurren t subdural haematoma was due to the very slow and intermittent venous bleed ing from the preexisting dural malformation, which progressively enlarged i n the following years to become very large. The symptoms of intracranial hy pertension and papilloedema may be explained by the increased pressure in t he dural sinus and the cerebral venous system. On the other hand, focal neu rological symptoms in our case resulted from the mass effect due to an aneu rysmally dilated draining vein in the left parieto-occipital region.