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Object: We report a case of endovascular treatment for a dural arteriovenous fistula (DAVF) of the anterior condylar confluence (ACC) with ocular symptoms.
Case presentation: A 70-year-old woman presented with left conjunctival injection, eyelid edema and abducens palsy. Angiograms revealed DAVF at the ACC. The arterial supply was the left ascending pharyngeal artery (APA) with retrograde venous drainage into the superior ophthalmic vein (SOV) through the ACC and inferior petrosal sinus (IPS). The patient was successfully treated with transvenous coil embolization.
Conclusion: DAVF of the ACC is relatively rare. Although most cases of ACC DAVF start with tinnitus, this case showed ocular manifestations very similar to DAVF of the cavernous sinus fistula as the initial symptoms. Endovascular treatment is usually feasible and effective, but an understanding of the venous anatomy and pathophysiology of the disease are of utmost importance when planning the approach.
