T1 post gad T2 Angiogram

Diagnosis: Dural AVF with presumed intraventricular meningioma.

It is believed that dural AVFs occur secondary to occlusion of the sinus with the fistula forming as a result of an attempt to recanalize the sinus. In addition to feeders from external carotid and meningeal branches off the vertebrals, intracranial dural branches and parasitized parenchymal vessels may supply these lesions as well. Patients are typically between 40 and 60 years of age and pulsatile tinnitus is a typical presenting complaint. The intraventricular lesion was discovered incidentally. The most likely diagnosis, given the low signal on T1 and T2, (not shown) and the homogeneous enhancement, is intraventricular meningioma. Only 2% of meningiomas have no attachment to the dura. In older patients astrocytoma as well as lymphoma and metastasis may be considered in the differential diagnosis of intraventricular tumors. Choroid plexus papilloma and ependymoma are very unusual in the lateral ventricles of adults. Related Cases

Pial AVM Dural AVF