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MR Imaging of Dural Arteriovenous Fistulas Draining into Cerebellar Cortical Veins

Seon-Kyu Leea, Robert A. Willinskya, Walter Montaneraa and Karel G. terBruggea

a From the Department of Medical Imaging, Division of Neuro-imaging, University of Toronto, Toronto Western Hospital, Ontario, Canada (all authors)



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  		FIG 1. Patient 1, a 73-year-old man who presented with incoordination and ataxia.

A, Parasagittal T1-weighted MR image shows a low-signal-intensity lesion involving the posterior inferior aspect of the cerebellar hemisphere.

B, Axial T2-weighted MR image shows an ill-defined high-signal-intensity lesion (asterisk) in the left cerebellar hemisphere. Note multiple signal voids in the peripheral portion of the lesion.

C, Axial gadolinium-enhanced T1-weighted image demonstrates intense peripheral enhancement of the left hemispheric lesion, with a central nonenhancing area.

D, Left external carotid artery angiogram demonstrates DAVF (short thick black arrow) supplied by meningeal artery of cerebellar (Mening. a. of Cbll.) fossa coming from a neuromeningeal branch of the right ascending pharyngeal artery and left occipital artery (Occp. A.) draining through the inferior hemispheric vein (curved arrow).



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  		FIG 2. A–C, Axial T2-weighted MR images in patient 5 (A), patient 2 (B), and patient 4 (C) show high signal intensity of the lesion, with various degrees of signal voids.



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  		FIG 3. A–C, Gadolinium enhanced T1-weighted MR images in patient 3 (A, coronal), patient 2 (B, axial), and patient 4 (C, coronal) show diffuse peripheral enhancement.



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  		FIG 4. A and B, Lateral (A) and anterioposterior (B) selective angiograms of the meningeal artery of the cerebellar (Mening. A. of Cbll.) fossa in patient 3 show a DAVF draining into the inferior vermian vein (Inf. Verm. V.) via a short tentorial sinus (Tent.S.).

C, Right vertebral angiogram in patient 4 demonstrates enlarged artery of the falx cerebelli (A.of Falx Cbll.) supplying a DAVF and draining into the right inferior hemispheric vein (Inf.Hemsp. V.) through the tentorial sinus (Tent.S.)





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X