Fig. 3. Findings for 30-year-old man presenting with exophthalmos and tinnitus.A. MR angiogram shows multiple fistulas in left orbital and left temporal.

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Presentation transcript:

Fig. 3. Findings for 30-year-old man presenting with exophthalmos and tinnitus.A. MR angiogram shows multiple fistulas in left orbital and left temporal regions. B. Left external angiogram in working projection shows intraosseous fistula fed by multiple feeders in left temporal bone. C. Non-subtracted spot image obtained just after injection of 12% NBCA by proximal coil-protected technique. Note refluxes to other feeders (short arrows) from fistula, which mimics phenomenon during Onyx (Medtronic) embolization. Long arrow indicates coil mass and final coil is not detached. D. Left internal carotid angiogram in working projection. Enlarged left ophthalmic artery is main feeding artery into shunt, which forms multiple venous pouches (asterisks) and then drains through superior ophthalmic vein and pterygoid plexus. E.Spot image obtained just after proximal coil-protected NBCA embolization. Coil delivery catheter is located at lacrimal branch of left ophthalmic artery (arrow). Final coil is not yet detached. F.Left common carotid angiogram shows complete occlusion of left temporal bone fistula and near-complete occlusion of left orbit fistula. G. 12-month follow-up MR angiogram shows no recurrence of fistulas in left orbit and left temporal bone. MR = magnetic resonance Fig. 3. Findings for 30-year-old man presenting with exophthalmos and tinnitus.A. MR angiogram shows multiple fistulas in left orbital and left temporal regions. B. Left external angiogram in working projection shows intraosseous fistula fed by multiple feeders in left temporal bone… Korean J Radiol. 2019 Aug;20(8):1285-1292. https://doi.org/10.3348/kjr.2019.0127