Opportunity to defeat the enemy is provided by the enemy

Vikas Bhatia (India) presents the case of a 60-year-old man with diabetes and hypertension. For the last three days, he had presented with swelling and watering of the eyes. The general examination was normal, but revealed bilateral proptosis with swollen eyelids and no palpable thrill. Imaging and DSA identified a left hypoglossal canal dural arteriovenous fistula (AVF).

Among the various management options, the team chose to treat the patient with transvenous embolization using coils and onyx.