FIGURE 1.
(A) Sagittal gadolinium-enhanced brain T1-weighted MRI showing superior sagittal sinus thrombosis (SSS) (red arrow) and torcular thrombosis (orange arrow), associated with signs of spontaneous intracranial hypotension, including engorgement of the straight sinus (blue arrow) and effacement of the suprasellar cistern (green arrow). (B) Axial gadolinium-enhanced brain T1-weighted MRI showing bilateral pachymeningeal enhancement (arrowheads), SSS thrombosis (red arrow), and reduced diameter of the lateral ventricles (purple arrows). (C) Right transverse venous sinus thrombosis (red arrow). (D) Hemorrhagic transformation of a right frontal parenchymal infarction due to cerebral venous sinus thrombosis.
FIGURE 2.
(A) Lateral decubitus right-sided digital subtraction dynamic myelography demonstrating a T7 for aminal dural cyst. (B) A cerebrospinal fluid-venous fistula originating from the cyst (yellow arrow). (C) Transvenous embolization of the fistula via catheterization of the azygos vein. The right T7 segmental vein (red arrow) was accessed using a 156 cm Headaway Duo catheter navigated through the epidural plexus (orange arrow) from the T8 segmental vein. (D)–(F) Post-embolization cone-beam CT images in sagittal (D), coronal (E), and axial (F) reconstructions showing successful embolization with Onyx.
FIGURE 3.
(A) Sagittal gadolinium-enhanced brain T1-weighted MRI 5 days after cerebrospinal fluid-venous fistula embolization, demonstrating resolution of superior sagittal (red arrow) and torcular (orange arrow) sinus thrombosis, as well as resolution of straight sinus engorgement (blue arrow). (B) Axial gadolinium-enhanced brain T1-weighted MRI showing resolution of bilateral pachymeningeal enhancement (arrowheads), recanalization of the superior sagittal sinus (red arrow), and increased lateral ventricle diameter (purple arrows). (C) Patent right transverse venous sinus (red arrow). (D) Stability of the hemorrhagic transformation of the frontal parenchymal infarction.