• Chang Wei Zhang, Wei Fu, Seidu A Richard, and Xiao Dong Xie.
• Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
• Medicine (Baltimore). 2019 Apr 1; 98 (14): e15026e15026.

RationaleDural arteriovenous fistulae (DAVF) are vascular disorders depicted with direct interconnection between dural arteries and cerebral venous sinuses and/or cortical veins. Only a hand full of cases have been reported in literature. DAVF obstructing the 3rd ventricle and quadrigeminal cistern resulting in hydrocephalus is very rare.Patient ConcernsWe present a 55-year-old female with 2 years history of headaches and blurring of vision. Cranial nerves examinations were unremarkable.DiagnosesMagnetic Resonance Imaging (MRI) and digital subtraction angiography showed multiple tortuous vascular malformation in the 3rd ventricle and quadrigeminal cistern resulting in obstructive hydrocephalus (OHC).InterventionsWe utilized endovascular embolization treatment option to obliterate the lesion. We used Onyx embolization agent (ev3 Neurovascular, Irvine, CA) to embolize the lesion via the transarterial route.OutcomesThe OHC resolved spontaneously after the endovascular embolization of the DAVF. The patient recovered with no further neurologic complication. Two years follow-up reveal no recurrence of the DAVF as well as hydrocephalus.LessonsAdequate knowledge on the vascular anatomy is very crucial in managing DAVF.

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