Dural arteriovenous fistula presenting as reversible Parkinsonism and cognitive decline mimicking progressive supranuclear palsy phenotype

Dural arteriovenous fistulas (DAVFs) may rarely present with rapidly progressive Parkinsonism and dementia. We report two patients presenting with rapidly progressive Parkinsonism, early postural instability, and cognitive decline consistent with a PSP-like phenotype. Brain MRI demonstrated extensive white matter hyperintensities with features of venous congestion. Digital subtraction angiography confirmed intracranial DAVFs with cortical venous reflux. Both patients underwent endovascular embolization, resulting in improved motor, cognitive, and oculomotor functions.