{"id":"0b695698-022c-4110-90d2-0bd6967806e1","slug":"four-dimensional-digital-subtraction-angiography-for-exploration-of-intraosseous-arteriovenous-fistula-in-the-sphenoid-bone","title":"Four-dimensional digital subtraction angiography for exploration of intraosseous arteriovenous fistula in the sphenoid bone","authors":["Toshihiro Ishibashi","Fumiaki Maruyama","Issei Kan","Tohru sano","Yuichi Murayama"],"abstract":"Background: Intraosseous arteriovenous fistula (AVF) is a rare clinical entity that typically presents with symptoms from their effect on surrounding structures. Here, we report a case of intraosseous AVF in the sphenoid bone that presented with bilateral abducens palsy. Case Description: A previously healthy man presented with tinnitus for 1 month, and initial imaging suspected dural AVF of the cavernous sinus. Four-dimensional digital subtraction angiography (4D-DSA) imaging and a three-dimensional (3D) fused image from the bilateral external carotid arteries revealed that the shunt was in a large venous pouch within the sphenoid bone that was treated through transvenous coil embolization. His symptoms improved the day after surgery. Conclusion: This is a case presentation of intraosseous AVF in the sphenoid bone and highlights the importance of 4D-DSA and 3D fused images for planning the treatment strategy.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/0b695698-022c-4110-90d2-0bd6967806e1/featured/hero-1781562683471.png","publishDate":"2021-03-02T00:00:00.000Z","doi":"10.25259/SNI_858_2020","categories":["Neurovascular","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/0b695698-022c-4110-90d2-0bd6967806e1/pdf"}