A Case of Dural Arteriovenous Fistula Involving the Inferior Petroclival Vein

Abstract

Objective: We report a very rare case of dural arteriovenous fistula (DAVF) involving the inferior petroclival vein (IPCV). Case Presentation : The patient was a 77-year-old woman. She suffered from right ophthalmalgia, pulsatile tinnitus, blepharedema, and chemosis, as well as right ptosis and diplopia (right oculomotor nerve palsy). Our imaging examinations demonstrated DAVF involving the IPCV. Since the proximal side of the right inferior petrosal sinus (IPS) was obstructed, the main venous drainage flow refluxed retrogradely from the IPS to the cavernous sinus (CS). Therefore, her clinical symptoms were similar to those of CS-DAVF. We successfully performed transvenous coil embolization (TVE) in the IPCV and IPS. Conclusion: We experienced a very rare case of DAVF involving the IPCV. We believe that it is important in each case to understand the 3D vascular anatomy by making full use of 3D-DSA and other modalities to accurately identify the shunt point and venous drainage structure.