Fig 1.

Case 1. Complex spinal dural and pial arteriovenous shunt. A 43-year-old man presented with SAH. A, The superselective anteroposterior view of the C2 dural feeder from the right vertebral artery reveals a DAVS that drains rostrally (black arrow). B, The superselective anteroposterior view of the anterior spinal artery from the left vertebral artery also reveals a pial arteriovenous fistula with an aneurysmal sac (white arrow). The rostral venous drainage route of the pial arteriovenous fistula shares the same drainage route of the DAVS (black arrows in A and B). Surgical resection was performed for both lesions with the patient showing good recovery on 19-month clinical follow-up.