An Intraosseous Pterygopalatine Fossa Dural Arteriovenous Fistula

Intraosseous dural arteriovenous fistulas (DAVFs) are distinct in that the fistula is located within the bone rather than the dura through which the dural vessels pass. It has been stated that only fistulas within marrow should be considered as intraosseous DAVFs rather than DAVFs with traditional angioarchitecture that erode into bone or are located within a bony foramen. The ambiguity in the definition may have contributed to the oversight and scarcity of relevant cases reported in the literature. Three- or four-dimensional digital subtraction angiography is useful for determining the location of the fistula and developing treatment plans. We present an intraosseous DAVF around the pterygopalatine fossa using a transvenous approach.