Fig 1.

Case 1.

A, Precontrast CT scan shows curvilinear calcification (arrowhead) in the cortico-medullary junction at the inferior part of the left temporal lobe.

B, Postcontrast T1-weighted image shows multiple foci of curvilinear enhancement along the gyri, indicating dilated venous channels due to reflux (arrowheads).

C, Lateral view of left external carotid angiogram shows dAVF at left transverse sinus fed by the middle meningeal artery (arrow) and cortical venous reflux (arrowhead).

D, SPECT shows markedly reduced blood flow in the left temporal lobe where the cortical venous reflux was found.