Fig. 2.

(A) TAE was performed for the shunt point occlusion. Injection from Scepter XC cannulated to the left OA shows shunt flow from the mastoid branch to the StS. Onyx 18 was injected intermittently with balloon inflation, a total of 1.6 mL in 10 minutes. (B) Arteriovenous shunt occlusion was confirmed on postembolization left OA angiography (asterisk, lateral view). (C) Postembolization right ICAG showing remnant of StS occlusion (C-1, arrow), and patency of CS as venous drainage route (C-2, arrow). (D) MRI FLAIR showing bilateral thalamus injury due to high venous pressure by StS DAVF. (E) Intraoperative neuroendoscopy showing hypervascularity on the ventricular wall (asterisk), suggesting congestion of venous return or the effect of angiogenesis. CS, cavernous sinus; DAVF, dural arteriovenous fistula; ICAG, internal carotid artery angiography; MRI FLAIR, magnetic resonance fluid-attenuated inversion recovery imaging; OA, occipital artery; StS, straight sinus; TAE, trans-arterial embolization.