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Explore this complex case of falcotentorial arteriovenous fistula embolization in a 57-year-old woman. She presented with a three-month history of headaches and bilateral pulsatile tinnitus. Imaging revealed a straight sinus AV fistula with multiple arterial feeders and venous reflux into the vein of Galen and the left basal vein of Rosenthal.
The fistula’s anatomy played a key role in planning the intervention. Which approach did the team choose: transarterial embolization, transvenous embolization, or straight sinus occlusion?