TY - JOUR T1 - Ethmoidal dural arteriovenous fistula with unusual drainage route treated by transarterial embolization JF - BMJ Case Reports DO - 10.1136/bcr-2013-011098 VL - 2014 SP - bcr2013011098 AU - Akihiro Inoue AU - Masahiko Tagawa AU - Yoshiaki Kumon AU - Hideaki Watanabe AU - Daisuke Shoda AU - Kenji Sugiu AU - Takanori Ohnishi Y1 - 2014/03/25 UR - http://casereports.bmj.com/content/2014/bcr-2013-011098.abstract N2 - 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. ER -