Discover the case of a 51 year-old woman with symptoms of progressive headache, orbital swelling and left pulsatile tinnitus. Physical exam showed bilateral proptosis (worse on left), orbital edema and conjunctival injection. MRI revealed a 5cm lesion from left pterygopalatine fossa to middle cranial fossa and an enlarged diploic frontal vein. DSA displayed a left sphenoid bone diploic vein fistula with intracranial shunting. What was the treatment approach? Which difficulties did they encounter? Watch this presentation from Mazen Noufal during LINNC Americas 2022 to find out!