In this case presented by Vincent Nguyen, a 77-year-old woman was admitted with severe headaches, vomiting, and mild lethargy, along with bilateral upper extremity ataxia. Imaging revealed a subarachnoid hemorrhage in the ambient cistern, as well as a venous varix at the pontomesencephalic junction, fed by tentorial arteries and draining into deep venous structures.
See the detailed treatment strategy to secure this ruptured high-grade dural arteriovenous fistula.