case_images: PMC4828949_01
case_images: Case 1 - (a) Axial T2-weighted GRE magnetic resonance sequence demonstrating superficial siderosis of the cerebral cortex near the vertex. (b) Cerebral angiography - anteroposterior projection cerebral digital subtraction angiography of the left internal carotid artery injection demonstrating Borden 1 methyl methacrylate to superior sagittal sinus dural arteriovenous fistula. (c and d) Postembolization anteroposterior and lateral nonsubtracted cerebral angiography films showing embolization cast of dural arteriovenous fistula
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case_images: PMC4828949_01_SNI-7-223-g001.jpg
case_images: F1
case_images: MRI revealed susceptibility artifact without associated fluid-attenuated inversion recovery nonsuppression along sulci predominately at the vertex [Figure 1a]. MR-angiography did not reveal any possible source for the findings. The diagnostic cerebral angiogram revealed a left parasagittal Borden Grade I dAVF supplied by arterial feeders from the frontoparietal trunk of the left middle meningeal artery with early venous drainage into the superior sagittal sinus (SSS) [Figure 1b]. The left parasagittal dAVF lesion was treated successfully using transarterial Ony x 34 and Ony x 18 embolization with no residual filling and no off-target embolization [Figure 1c-d].
case_images: PMC4828949_02
case_images: Case 2 - Lateral projections of cerebral digital subtraction angiography showing methyl methacrylate to superior sagittal sinus dural arteriovenous fistula (a-c) with successful endovascular embolization (d)
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case_images: PMC4828949_02_SNI-7-223-g002.jpg
case_images: F2
case_images: Conventional angiography showed a Borden III splenic AVF, which was supplied by the right middle meningeal artery and drained into the SSS with cortical venous reflux into the vein of Trolard [Figure 2a-c]. Embolization was carried out from the proximal portion of the pedicle with optimal penetration into the fistula resulting in angiographic cure and return of antegrade flow in the vein of Trolard [Figure 2d].