Arteriovenous fistula involving the foramen cecum vein

Background Dural arteriovenous fistulas (dAVF) arising in the anterior fossa require treatment as they inherently possess cortical venous drainage. The foramen cecum (FC) contains a venous structure that is infrequently observed in humans due to its small size, and dAVF rarely involve the FC. Case Presentation We report a unique case of an ethmoidal dAVF with venous drainage via the FC vein. This fistula was successfully treated through a bicoronal craniotomy for disconnection. Conclusions The FC vein is clinically relevant when involved in the drainage pathway of dAVF. Given the predictable location of anterior fossa dAVF draining via the foramen cecum vein, more minimally invasive surgical approaches exposing the foramen cecum are sufficient to disconnect the fistula.