# Superior sagittal sinus occlusion combined with dural arteriovenous fistula presenting as Fahr-like pattern: a case report

## TL;DR

A 64-year-old man with tremors and seizures was found to have a rare brain condition involving a dural arteriovenous fistula and sinus occlusion, mimicking a Fahr-like pattern.

## Contribution

This case report highlights the rare and complex presentation of DAVF with Fahr-like imaging features and emphasizes the importance of DSA for accurate diagnosis.

## Key findings

- The patient exhibited involuntary tremors, seizures, and cognitive decline due to DAVF and superior sagittal sinus occlusion.
- Imaging showed intracranial calcifications and venous hypertension, mimicking Fahr disease but confirmed as DAVF via DSA.
- The case underscores the need for multi-factor evaluation and DSA in diagnosing atypical neurological presentations.

## Abstract

Dural arteriovenous fistula (DAVF) presents with diverse clinical manifestations and is susceptible to misdiagnosis. Herein, we report a case of a 64-year-old male patient who manifested involuntary tremors in the left limb, epileptic seizures, and cognitive decline. Imaging examinations revealed multiple intracranial calcifications, predominantly located in the right cerebral hemisphere, accompanied by occlusion of the superior sagittal sinus. The diagnosis of DAVF was confirmed via digital subtraction angiography (DSA). The patient's symptoms were complex, involving venous hypertension, impaired calcium metabolism, and abnormal motor cortex activity. This case emphasizes the necessity of considering DAVF in patients with unexplained movement disorders and intracranial calcium deposition, and highlights the critical role of DSA in diagnosis. By clarifying the uncommon manifestations of DAVF, this case provides a clinical reference to enhance clinicians’ awareness of this condition and underscores the importance of comprehensive multi-factor evaluation.