Figure 1
From: Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA
Brain MRI, brain CT, and digital subtraction angiography (DSA) of the two cases. Case 1. The baseline diffusion-weighted imaging (DWI) revealed no signal changes (A), while the perfusion-weighted imaging (PWI) showed a mean transit time (MTT) delay [interhemispheric ratio (IR) 1.07] and increase of relative cerebral blood volume (rCBV; IR 1.04) in the right postcentral gyrus (B, C). After neurological deterioration, a brain CT revealed a multiple lobar ICH in the right fronto-parietal lobe (D). A lateral view of the external carotid artery (ECA) on digital subtraction angiography (DSA) revealed a right middle meningeal artery-vein fistula with cortical venous reflux (E, F). Case 2. The baseline DWI showed no signal changes (G), whereas there were signal void signs in the left parietal cortex on the gradient echo MRI (H) and increase of MTT (IR 1.04) and rCBV (IR 1.24) on the PWI in the left paracentral sulcus area (I, J). Lateral (I) and frontal (J) views of the left ECA on DSA revealed arteriovenous fistula with single cortical venous reflux fed by the left middle meningeal artery.