A 58-year-old man (patient 1) with a good-grade (Hunt and Hess II) subarachnoid hemorrhage from a torcular DAVF that was cured with a single Onyx injection.

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Presentation transcript:

A 58-year-old man (patient 1) with a good-grade (Hunt and Hess II) subarachnoid hemorrhage from a torcular DAVF that was cured with a single Onyx injection from the middle meningeal artery. A 58-year-old man (patient 1) with a good-grade (Hunt and Hess II) subarachnoid hemorrhage from a torcular DAVF that was cured with a single Onyx injection from the middle meningeal artery. A and B, Left external carotid angiograms in arterial (A) and venous (B) phases demonstrate a DAVF located on the torcula supplied by the middle meningeal and occipital arteries with marked congestion of cerebellar and even perimedullary veins. C, Supply to the DAVF by the posterior meningeal artery arising from the right vertebral artery. D, Microcatheter distally in the middle meningeal artery close to the fistula used for Onyx injection. E, AP view of selective angiography of the posterior meningeal artery (arrow) arising from the right vertebral artery. F, Same view as in E shows an Onyx cast in the draining vein and retrograde in the posterior meningeal artery (double arrows). G–I, Lateral views of Onyx cast (G), external carotid (H), and right vertebral (I) angiogams 10 weeks after embolization demonstrate complete occlusion of the DAVF. W.J. van Rooij, and M. Sluzewski AJNR Am J Neuroradiol 2010;31:1516-1520 ©2010 by American Society of Neuroradiology