Abstract
Objective: There have been no reports on the dural arteriovenous fistula (dAVF) of the occipital sinus (OS). We present a case of dAVF involving the OS.
Case presentation: A 51-year-old woman suffered from pulsating tinnitus for a year and gradually worsening tinnitus. Angiograms showed the presence of a dAVF fed by the bilateral occipital arteries and bilateral middle meningeal arteries. The fistula was located in the occipital sinus and drained into the bilateral transverse sinuses. Cortical venous reflux was not observed. We chose transvenous embolization (TVE). A microcatheter was introduced into the fistulous pouch of the OS via the left transverse sinus (TS). Six detachable coils were placed in the fistulous pouch, and an angiogram showed complete occlusion of the dAVF. After the procedure, there was no observable neurological deficit or tinnitus.
Conclusion: dAVF draining into the OS is very rare. It is important to identify the fistulous point by 3-dimensional rotational angiography (3D-RA). Hemodynamic function of the OS, in particular, should be evaluated to perform transvenous embolization.
