case_images: PMC11004272_01
case_images: Brain MRI and MRV. The axial section of the T2-weighted image (A,B) and the diffusion-weighted image (C,D) reveal bilateral symmetrical hyper-intensities in the basal ganglia and brain stem (white asterisk). The lesions present with hyperintensity on fluid attenuated inversion recovery (FLAIR) images (E), and no enhancement on enhancing MRI (F). The MRV (G,H) indicates a filling defect in the right transverse, left sigmoid, and superior sagittal sinuses.
case_images: fneur-15-1336593-g001.jpg
case_images: PMC11004272_01_fneur-15-1336593-g001.jpg
case_images: fig1
case_images: These lesions showed restricted diffusion on diffusion-weighted imaging and no enhancement (as seen in Figures 1A-F). Additionally, magnetic resonance venography (MRV) highlighted dilated veins and a filling defect, pointing to possible sinus thrombosis in the superior sagittal sinus (as seen in Figures 1G,H).
case_images: Cerebral angiography. (A-C) The angiogram showcases a fistula (red arrow) connecting the torcular herophili to the transverse-sigmoid sinuses, with blood supply from the occipital artery (red arrowhead) and the deep cervical artery (red arrowhead). (D) The DAVF drained into the straight sinus, which flowed in a retrograde direction into the vein of Galen, as well as into the internal cerebral veins and basal vein of Rosenthal.
case_images: fneur-15-1336593-g002.jpg
case_images: PMC11004272_01_fneur-15-1336593-g002.jpg
case_images: fig2
case_images: Cerebral angiography further confirmed thrombosis in the vein of Galen and identified a DAVF between the torcular herophili and transverse-sigmoid sinuses, fed by the occipital artery and arteria cervicalis profunda (as shown in Figure 2).
case_images: Time course of symptoms, diagnosis, and treatment.
case_images: fneur-15-1336593-g003.jpg
case_images: PMC11004272_01_fneur-15-1336593-g003.jpg
case_images: fig3
case_images: The time course of symptoms, diagnosis, and treatment is shown in Figure 3.