{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:03Z","timestamp":1756325403704,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,12,13]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Dural arteriovenous fistulas (DAVFs) are intracranial vascular abnormalities in which one or more meningeal arteries shunt into a venous structure, either a cortical vein or a venous sinus, causing cerebral venous hypertension and risk of haemorrhage. Imaging diagnosis and characterisation are of paramount importance to grade the haemorrhagic risk and direct management. Non-invasive vascular neuroimaging might pose a diagnostic suspicion, but invasive catheter digital subtraction angiography (DSA) is usually required. We present the case of a patient with an atypical acute cerebral haemorrhage in which admission imaging with CT angiography (CTA) and MR angiography (MRA) was unremarkable, while advanced morphological MR with susceptibility-weighted imaging (SWI) revealed specific findings suggesting unilateral chronic venous hypertension. Successively, DSA detected a small DAVF that was treated with endovascular embolization. This case report raises awareness on subtle but important conventional imaging findings that suggest the presence of an AV shunt, to avoid misdiagnosis and delayed treatment.<\/jats:p>","DOI":"10.1136\/bcr-2023-258685","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T10:35:26Z","timestamp":1703932526000},"page":"e258685","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["The \u2018corkscrew\u2019 sign: an indirect MRI hint for intracranial venous hypertension"],"prefix":"10.1136","volume":"16","author":[{"given":"Nicola","family":"Pinna","sequence":"first","affiliation":[{"name":"Department of Neuroradiology, Neurocenter of Southern Switzerland - EOC, Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Piccoli","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Neurocenter of Southern Switzerland - EOC, Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Pileggi","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Neurocenter of Southern Switzerland - EOC, Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Cianfoni","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Neurocenter of Southern Switzerland - EOC, Lugano, Switzerland"},{"name":"Department of Diagnostic and Interventional Neuroradiology, Inselspital University Hospital, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"2025082712485652000_16.12.e258685.1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2798"},{"key":"2025082712485652000_16.12.e258685.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0160495","article-title":"Focal and generalized patterns of cerebral cortical veins due to non-convulsive status epilepticus or prolonged seizure episode after convulsive status epilepticus - A MRI study using susceptibility weighted imaging","volume":"11","author":"Verma","year":"2016","journal-title":"PLoS One"},{"key":"2025082712485652000_16.12.e258685.3","doi-asserted-by":"crossref","first-page":"110800","DOI":"10.1016\/j.ejrad.2023.110800","article-title":"Differentiation between aggressive and benign intracranial non-cavernous dural arteriovenous fistulas using cortical venous reflux on susceptibility weighted images","volume":"162","author":"Tritanon","year":"2023","journal-title":"Eur J Radiol"},{"key":"2025082712485652000_16.12.e258685.4","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012314"},{"key":"2025082712485652000_16.12.e258685.5","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2777"},{"key":"2025082712485652000_16.12.e258685.6","doi-asserted-by":"crossref","DOI":"10.3174\/ajnr.A1265","article-title":"Susceptibility-weighted imaging in cranial dural arteriovenous fistulas: fig 1","volume":"30","author":"Saini","year":"2009","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082712485652000_16.12.e258685.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1973"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258685","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:49:03Z","timestamp":1756324143000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":7,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12,30]]},"published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1136\/bcr-2023-258685"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258685","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,12]]}}}