Transarterial Embolization via the Occipital Artery for a Posterior Condylar Canal Dural Arteriovenous Fistula...

Posterior condylar canal dural arteriovenous fistula is rare, and cases of posterior condylar canal dural arteriovenous fistula directly related to trauma have been reported even less frequently. We describe a case of posterior condylar canal dural arteriovenous fistula that presented with tinnitus soon after head trauma and was successfully treated with transarterial embolization. A 60-year-old man presented with right-sided tinnitus that had persisted for 2 weeks after sustaining a right temporal injury. Digital subtraction angiography revealed a posterior condylar canal dural arteriovenous fistula with venous drainage from the posterior condylar vein to the suboccipital cavernous sinus, without cortical venous reflux. The shunt was supplied by a single feeder, the jugular branch of the occipital artery. Transarterial embolization using N-butyl cyanoacrylate and coils achieved complete occlusion of the shunt. The patient's tinnitus resolved immediately after the procedure, and follow-up angiography demonstrated persistent complete occlusion of the fistula, with no evidence of recurrence. Posterior condylar canal dural arteriovenous fistula is a rare lesion that may occur following head trauma. Bone-window three-dimensional angiographic reconstruction is useful for diagnosis, as it clearly delineates the relationship between the skull base canal and the shunt. Transarterial embolization can be a curative treatment option when performed with a thorough understanding of the relevant vascular anatomy and potentially hazardous anastomoses.