Primary Intraventricular Hemorrhage Isolated in Cerebral Aqueduct Secondary to Dural Arteriovenous Fistula

Abstract

Objective—We report a case of dural arteriovenous fistula (dAVF) presenting as isolated cerebral aqueduct hemorrhage.
Result—A 73-year-old man with a history of hypertension and chronic alcoholism presented with altered
mental status and gait difficulties, bilateral fronto-occipital headaches, and intermittent dizziness. He had
bilateral upward gaze restriction. Computerized tomography scan showed hyperdensity in the cerebral
aqueduct and dilation of the lateral and third ventricles. The diagnostic angiogram demonstrated dAVF with
arterial feeders from the cavernous segment of the left internal carotid artery and venous drainage into left
transverse and sigmoid venous sinus.
Conclusion—Underlying dAVF should be considered in patients with isolated cerebral aqueduct hemorrhage.