Dural arteriovenous malformations and intracranial hemorrhage.

Intracranial hemorrhage is seen less frequently with dural than with intraparenchymal arteriovenous malformations (AVMs). We report 6 cases of intracranial hemorrhage among our past 10 patients with dural AVMs. A literature search provided 27 other cases of intracranial hemorrhage from a total of 213 reported dural AVMs. Although hemorrhage was relatively infrequent (7.5%) with dural AVMs located primarily within a major venous sinus, bleeding episodes occurred in 20 of the 39 (51%) cases of malformation outside a major sinus. There was primary leptomeningeal venous drainage in all cases with hemorrhage, and a large variceal dilatation was seen in 14 cases (42%). Dural AVMs located outside a major sinus are uncommon, and they have a propensity for serious intracranial hemorrhage.