title: Posterior fossa dural arteriovenous fistula presenting clinically as a carotid-cavernous fistula treated by a direct access cavernous sinus approach.
abstract: Dural arteriovenous fistulas (dAVFs) represent approximately 10-15% of all cerebral vascular malformations. Although dAVFs can occur anywhere in the brain, they occur most frequently in the cavernous and transverse-sigmoid sinuses. Posterior fossa dAVFs presenting clinically as carotid-cavernous fistulae (CCF) are rarely encountered in clinical practice. We discuss and illustrate an unusual case of a left posterior fossa dAVF that presented clinically with chemosis and early visual impairment, similar to that of CCF. This was subsequently treated by a direct access cavernous sinus approach. We describe the technique used to access the cavernous sinus directly in cases where conventional transvenous and transarterial routes have been exhausted.
authors.affiliation: Department of Neuroradiology, National Neuroscience Institute, Singapore.
authors.forename: Ai Peng
authors.initials: AP
authors.lastname: Tan
authors.affiliation: Department of Neuroradiology, National Neuroscience Institute, Singapore.
authors.forename: Manish
authors.initials: M
authors.lastname: Taneja
authors.affiliation: Department of Neuroradiology, National Neuroscience Institute, Singapore.
authors.forename: Francis
authors.initials: F
authors.lastname: Hui
mesh_terms: D015901:Angiography, Digital Subtraction; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis*; D002426:Cavernous Sinus / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D057510:Endovascular Procedures / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging
keywords: Fistula; Posterior fossa; Technique; Vascular Malformation