A case of transverse-sigmoid sinus junction dural arteriovenous fistula in which another shunted pouch was identified during embolization

Abstract

Objective: We report a case of transverse-sigmoid sinus junction dural arteriovenous fistula (DAVF) in which selective angiography of each feeder revealed another shunted pouch during embolization. Case Presentation: Head MRA of 72-year-old man, who developed cerebral infarction a year ago showed de novo DAVF. Preoperative angiography demonstrated multiple shunted pouches around the left transverse-sigmoid junction. Transvenous embolization was performed under the control of angiography in the left occipital artery and left vertebral artery. In the process of sequential embolization of shunted pouches, another shunted pouch was newly identified. After the embolization of the newly identified shunted pouch, the cortical reflux and shunt flow was disappeared. Conclusions: It is useful to compare selective angiographies of feeding arteries precisely for identification of various shunted pouches.