Fig 2.

Case 2. Imaging of a 36-year-old man presenting with a left-sided pulse-synchronous tinnitus due to a Cognard type IV DAVF. A, Early arterial, late arterial, and venous phase of 4D-CTA (upper row, MIP, lateral view) and CA (lower row, lateral view, internal carotid artery injection). The arrow indicates a DAVF at the level of the superior petrosal sinus; large arrowheads, venous pouches in the basal vein of Rosenthal and its tributary from the fistula; and thin arrowheads, the inferolateral and meningohypophyseal trunks. B, Lateral view after selective injection of the common trunk of the left ascending pharyngeal artery and occipital artery. The arrowhead indicates the stylomastoid branch feeding through the facial arcade; the arrow, the clival branches of the neuromeningeal trunk of the ascending pharyngeal artery; and the thin arrowhead, the second draining vein coursing directly toward the torcular.