Primary Intraventricular Hemorrhage Isolated in Cerebral Aqueduct Secondary to Dural Arteriovenous Fistula.

Objective: We report a case of dural arteriovenous fistula (dAVF) presenting as isolated cerebral aqueduct hemorrhage.

Result: A 73-year-old man with a history of hypertension and chronic alcoholism presented with altered mental status and gait difficulties, bilateral fronto-occipital headaches, and intermittent dizziness. He had bilateral upward gaze restriction. Computerized tomography scan showed hyperdensity in the cerebral aqueduct and dilation of the lateral and third ventricles. The diagnostic angiogram demonstrated dAVF with arterial feeders from the cavernous segment of the left internal carotid artery and venous drainage into left transverse and sigmoid venous sinus.

Conclusion: Underlying dAVF should be considered in patients with isolated cerebral aqueduct hemorrhage.