%0 Journal Article %A Akihiro Inoue %A Masahiko Tagawa %A Yoshiaki Kumon %A Hideaki Watanabe %A Daisuke Shoda %A Kenji Sugiu %A Takanori Ohnishi %T Ethmoidal dural arteriovenous fistula with unusual drainage route treated by transarterial embolization %D 2014 %R 10.1136/bcr-2013-011098 %J BMJ Case Reports %P bcr2013011098 %V 2014 %X Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. In particular, this entity with reflux drainage directly into the ophthalmic vein is extremely rare. We report a case of ethmoidal dural AVF with direct drainage of the superior ophthalmic vein (SOV) and inferior ophthalmic vein (IOV), successfully treated by endovascular surgery. A 58-year-old man presented with progressive diplopia. Angiography and contrast-enhanced CT showed an ethmoidal dural AVF supplied via the bilateral anterior ethmoidal arteries and venous drainage through the left SOV and IOV. A transarterial approach through the bilateral anterior ethmoidal arteries was used to place the microcatheter close to the fistula site. After intra-arterial embolization with 20% N-butyl cyanoacrylate, the dural AVF was completely occluded. In patients with good vascular access, endovascular transarterial embolization may be an effective and less invasive treatment strategy for ethmoidal dural AVF. %U https://casereports.bmj.com/content/casereports/2014/bcr-2013-011098.full.pdf