Left anterior condylar confluence (ACC) dural arteriovenous fistula (DAVF)

CASE PRESENTATION

• 52-year-old male patient presenting with severe left pulsatile tinnitus
• Digital subtraction angiography (DSA) showed a left anterior condylar confluence (ACC) dural arteriovenous fistula (DAVF) with arterial feeders arising mainly from the neuromeningeal division of ascending pharyngeal artery
• The fistula had dominant anterograde venous drainage to the internal jugular vein and to the vertebral venous plexus
• The ACC DAVF was treated with transvenous coil occlusion of the fistulous pouch in the ACC, followed by ethylene vinyl alcohol (EVOH) injection
• Symptoms resolved immediately after intervention and the patient was discharged without any neurological deficits

IMAGES