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Advanced Neurology

CASE REPORT
Seizure as the first symptom of cavernous sinus

dural arteriovenous fistula: A case report and
literature review

†
Mengxin Li , Shuai Jia , Jian Li, Jianhong Geng, Xiaojun Zhang, and
†
Yanqiang Wang*
Department of Neurology II, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong,
China

Abstract
Cavernous sinus dural arteriovenous fistula (CS-DAVF) is an abnormal arteriovenous
communication associated with a variety of clinical manifestations. The previous
literature has rarely reported the occurrence of CS-DAVF with seizures and cerebral
hemorrhage, signaling the need for more case reports and literature review in this
area. A 62-year-old Chinese female presented with a paroxysmal loss of consciousness,
accompanied with involuntary eye movement to the left, chewing issues, salivation
at the right corner of the mouth, and bit tongue. The brain computed tomography
revealed that the left temporal lobe was hemorrhagic. Brain scan and contrast-
enhanced magnetic resonance imaging showed diffuse meningeal enhancement
† These authors contributed equally and lesions in the left frontoparietal temporal lobe, insular lobe, and hippocampal
to this work.
head region. Electroencephalography demonstrated continuous emission of
*Corresponding author: spike and slow waves in the left hemisphere. With the aid of digital subtraction
Yanqiang Wang
(wangyq6@mail3.sysu.edu.cn) angiography, the patient was confirmed with a diagnosis of CS-DAVF draining into
the ipsilateral cavernous sinus, intercavernous sinus, contralateral cavernous sinus,
Citation: Li M, Jia S, Li J, Geng J,
Zhang X, Wang Y. Seizure as the left superior ophthalmic vein, left lateral fissure vein, and left pterygoid venous
first symptom of cavernous sinus plexus. The fistula was closed with interventional embolization through the femoral
dural arteriovenous fistula: A case vein, and immediate angiography showed complete resolution of CS-DAVF after
report and literature review. Adv operation. The patient did not manifest any post-operative complications. This case
Neuro. 2024;3(1):0980.
https://doi.org/10.36922/an.0980 highlights that the prevention of epilepsy, cerebral hemorrhage, and other serious
complications is extremely important for good prognosis, especially in some patients
Received: May 23, 2023
presenting with serious clinical symptoms. It also sheds light on the necessity to
Accepted: October 12, 2023 consider the diagnosis of CS-DAVF if seizures, although extremely rare, are present.
Published Online: November 9,
2023
Keywords: Cavernous sinus dural arteriovenous fistula; Epileptic seizures; Digital
Copyright: © 2024 Author(s). subtraction angiography; Interventional embolization; Case report
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Background
provided the original work is
properly cited. Cavernous sinus dural arteriovenous fistula (CS-DAVF) refers to an abnormal
Publisher’s Note: AccScience communication between the dural branches and the venous sinus, that occurs in the
Publishing remains neutral with cavernous sinus area . The patients with CS-DAVF show a series of clinical manifestations
[1]
regard to jurisdictional claims in
published maps and institutional and symptoms, which are rarely invasive, such as intracranial hemorrhage, cerebral
affiliations. infarction, convulsion, and so on. In many cases, patients develop ocular symptoms

Volume 3 Issue 1 (2024) 1 https://doi.org/10.36922/an.0980