Dural AVF 52 year old right-handed gentleman with 3 month history of worsening unsteadiness. ROS significant for left pulsatile tinnitus over past 2 years.

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Presentation transcript:

Dural AVF 52 year old right-handed gentleman with 3 month history of worsening unsteadiness. ROS significant for left pulsatile tinnitus over past 2 years. Neurologic exam significant for diminished tandem gait. Otherwise, non-contributory. HEENT: Left retroauricular bruit. Imaging: –Head CT negative –MRI-- retrospectively suggestive of left transverse sinus DAVF

Shunt further explored by microcatheter angiographies of the left occipital and middle meningeal arteries

Venous access

Placement of Stent Across Venous Sinus Stenosis

Balloon Inflation Across Shunt Site

NBCA Embolization

Post-embolization LECA Angiography

Post-embolization LICA Angiography

Post-embolization LICA- Sparing The Left Transverse Sinus

Post-embolization LCCA Angiography

Post-embolization LVA ANGIOGRAPHY