Upper left image: Sagittal T1WI shows some serpiginous flow voids within
the interhemispheric fissure posteriorly.
Right images: Axial T2-weighted images reveal additional enlarged vascular
structures around the brain stem and within the quadrigeminal cistern.
T1WIs with gadolinium show multiple serpiginous enhancing vascular
structures within the basal cisterns, and cerebral and cerebellar sulci.
Upper left image: Gd-enhanced T1WI reveals some enhancement of the right
transverse sinus but very little on the left side.
Upper right image: Coronal MR angiogram demonstrates normal arteries.
Bottom images: Sagittal MRA shows no flow in straight sinus or the posterior aspect
of the superior sagittal sinus. Some vascular structures in the region of the sinuses
are probably collateral veins.
Upper image: Lateral view of left external carotid angiogram discloses enlarged
branches of the middle meningeal, posterior auricular, and occipital arteries coursing
toward the posterior fossa.
Lower images: AP and lateral views of left vertebral injection show multiple enlarged
dural branches from the vertebral artery.
Upper left image: Lateral view of left internal carotid angiogram shows an enlarged
tentorial artery arising from the meningohypophyseal trunk.
Upper right image: Lateral view of right external carotid angiogram reveals
additional enlarged branches of the middle meningeal and occipital arteries.
Lower left image: A retrograde injection of the right internal jugular vein reveals occlusion.
Lower right image: An oblique view of a selective left occipital angiogram demonstrates
a dural AV fistula involving the left transverse sinus, as well as stenosis of the sinus.
Key words: mri angiography vascular mra
Dural AVM with occlusion of right sigmoid sinus,
superior sagittal sinus, & straight sinus
& stenosis of the left transverse sinus.