Dural Arteriovenous Fistula Mimicking a Supratentorial Tumor.

Abstract

The pathophysiology of dural arteriovenous fistulas (dAVF) is not fully understood. Retrograde venous flow can lead to venous congestion and disruption of the blood-brain barrier, resulting in diffuse contrast enhancement. We present the case of a patient with a supratentorial dAVF associated with a solid, tumor-appearing, corticosubcortical contrast-enhancing lesion. Surgical occlusion of the dAVF was followed by complete regression of the contrast-enhancing lesion. Histologic analysis of the lesion showed normal brain tissue. This case report highlights how venous congestion is an important differential diagnosis in contrast-enhancing lesions associated with dAVF and how it should be taken in consideration to avoid radiologic misdiagnoses and unnecessary treatment.