Internal jugular vein fistula mimicking dural arteriovenous fistula after cardiac pacemaker placement

Carotid jugular arteriovenous fistulas are a documented complication of cannulation of the internal jugular vein. They may present with neck pain, headache, and cardiovascular aberrations. However, carotid jugular fistula secondary thrombus formation after jugular cannulation with radiographic presentation similar to dural arteriovenous fistula has not yet been reported in the literature. Below, we report the case of a 68-year-old male with an incidentally found carotid-jugular fistula secondary to pacemaker placement who had intracranial reflux on imaging, which was ultimately treated successfully through an endovascular approach.