Neuroimaging and diagnosis

Abstract The diagnosis of dural arteriovenous fistula may be anticipated in patients with pulsatile tinnitus, ophthalmologic symptoms, or an intracranial hemorrhage. Patients presenting focal or global neurological deficits or even Parkinsonism or dementia may have a more circuitous route to their ultimate diagnosis. Noninvasive imaging modalities may harbor a variety of clues. Particularly lesions with cortical venous reflux may be identified by enhancing serpiginous or “corkscrew” veins seen on CT angiography or contrast-enhanced MRI. These “wandering” veins do not form a well-organized nidus or harbor discrete supply from typically enlarged pial feeders in contrast to pial arteriovenous malformations.