case_images: PMC10897943_01
case_images: The patient's MRI images. Time-of-flight magnetic resonance angiography (3.0 scanner, TR=24ms, TE=2.7ms) showed high signal intensity in the left jugular bulb, sigmoid sinus, transverse sinus, and the proximal side of the sagittal sinus (A, B: source images, C: maximum intensity projection image). The arterial spin labeling image also revealed hyperintensity in the cavernous sinus (D).
case_images: cureus-0016-00000053092-i01.jpg
case_images: PMC10897943_01_cureus-0016-00000053092-i01.jpg
case_images: FIG1
case_images: The TOF MRA revealed high signal intensity in the left sigmoid sinus, transverse sinus, IJV, and the proximal side of the superior sagittal sinus (Figures 1A-1C). TOF MRA (Figure 1D). These findings were initially suggestive of DAVF.
case_images: Digital subtraction angiography (DSA) images. The DSA with the left common carotid artery injection showed stagnation in the left sigmoid sinus and cavernous sinus and reflux into the right superior ophthalmic vein (A-C). The DSA with left subclavian artery injection demonstrated retrograde venous flow into the left internal jugular vein from the subclavian vein via the left forearm arteriovenous fistula.
case_images: cureus-0016-00000053092-i02.jpg
case_images: PMC10897943_01_cureus-0016-00000053092-i02.jpg
case_images: FIG2
case_images: Subsequently, retrograde flow occurred into the right superior ophthalmic vein via the intercavernous sinus in the late phase (Figures 2A-2C). There was no stenosis in the brachiocephalic vein (Figure 2D).