Transverse and Sigmoid Sinus Dural Arteriovenous Fistula Mimicking Idiopathic Intracranial Hypertension and Carotid Cavernous Fistula

Abstract

Intracranial dural arteriovenous fistulas (dAVFs) can produce a variety of symptoms depending on fistula location, size, and venous drainage. Although cavernous sinus fistulas (CCFs) classically present with symptoms of orbital venous congestion due to retrograde venous drainage into the superior ophthalmic vein (i.e. an arterialised “red eye”) (Miller NR. Neurosurg Focus 2007;23:1--15), dAVFs not localised to the cavernous sinus rarely present with a “red eye” and instead produce increased intracranial pressure, which can mimic idiopathic intracranial hypertension (IIH). The authors present a unique case of an intracranial dAVF with clinical features suggestive of both CCF and IIH. Clinicians should be aware of this possibility to avoid delayed diagnosis of the intracranial dAVF.

• Carotid-cavernous fistula
• cerebral venous sinus thrombosis
• dural arteriovenous fistula
• idiopathic intracranial hypertension
• red eye

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

 This work was supported in part by an unrestricted grant from Research to Prevent Blindness.

Note: Figures 1, 2 and 8 of this article are available in colour online at www.informahealthcare.com/oph