Abstract
A 67-year-old man presented with consciousness disturbance and right hemiparesis. Computed tomography (CT) scan showed an intracerebral hematoma with two enhanced vascular lesions. Digital subtraction angiography revealed the dural arteriovenous fistula (dAVF) in the falx cerebri which was supplied by both bilateral middle meningeal arteries and left pericallosal artery and drained into both the superior sagittal sinus and the vein of Galen via the posterior callosal vein accompanied by two venous pouches. The dAVF was obliterated by a combination of the endovascular and the direct surgeries. A dAVF in a falx cerebri is very rare and only five cases were reported. Clinical characteristics of the dAVFs are uncertain. Before deciding the strategy of treatment, it is important to consider the pathological condition including embryology of the falx, the falcine sinus, and the falcine venous plexus.