Complications Related to Percutaneous Transarterial Embolization of Intracranial Dural Arteriovenous Fistulas in 40 Patients

A 41-year-old man presented with a DAVF involving the left cerebellar tentorium. Left vertebral angiograms, frontal projection (A) and lateral projection (B), show a DAVF involving the left cerebellar tentorium supplied by the posterior meningeal artery and branches of the left posterior cerebral artery with a venous aneurysm (white arrow); the posterior meningeal artery was tortuous (double arrowheads). After embolization, a left vertebral angiogram, anteroposterior projection (C) revealed complete obliteration of the DAVF and P2 segment of the left PCA. Left common carotid angiogram, lateral projection (D), shows collateral flow to the left PCA territory. CT scanning (E) on the first day after the procedure demonstrated infarction in the left cerebellum (white arrow). The hyperdense areas (prepontine and premesencephalic cistern) are Onyx cast.

Right external carotid angiograms (A and B) show the DAVF supplied by the branches of the right middle meningeal artery and right occipital artery, with draining into the left sigmoid sinus. Note superior sagittal sinus reflux and occlusion of the right sigmoid sinus. Right internal carotid angiogram (C) and right vertebral angiogram (D) show that the DAVF was also fed by the suppliers from the right internal carotid artery and the right posterior cerebral artery.