Ocular Symptoms Associated with a Dural Arteriovenous Fistula of the Anterior Condylar Confluence: Case Report

A Case of Dural Arteriovenous Fistula Involving the Inferior Petroclival Vein

“…5) based on the intraoperative findings combined with the detailed findings of multi-planer reconstruction (MPR) prepared by rotational angiography presented in a book written by Kiyosue et al 10) Pulsatile tinnitus is observed in many cases of DAVF of the ACC and that located around the hypoglossal canal, and symptoms, such as hypoglossal nerve palsy, have been reported, 5,6,11) but obstruction of the proximal side of the IPS may cause reflux into the CS, SOV, and SMCV and mainly induce ocular symptoms similar to those of DAVF of the CS, to which attention should be paid. 4,5,9,[11][12][13][14][15] The present case was similar to a previous case report in which blood flow refluxed in the IPS into the CS due to obstruction of the main venous drainage route, the proximal side of the IPS, and further reflux into the SOV mainly induced ocular symptoms similar to those of DAVF of the CS.…”

“…For treatment, TVE (occasionally, transarterial embolization [TAE] and TAE + TVE) is mainly performed. [5][6][7][8]11,13,15,16) Since the vein distribution is complex, 17) to accurately identify the shunt point and vein distribution, it is important to carefully investigate a treatment strategy and access route by making full use of 3D-DSA and understanding the 3D vascular anatomy of each case. 11,14) Treatment by TVE retrogradely through the SOV 18) and TVE using Onyx as an embolic material 8) have also been reported.…”