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AJNR - American Journal of Neuroradiology

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CT-Demonstrated Transcalvarial Channels Diagnostic of Dural Arteriovenous Fistula

Steven Alatakis^a, George Koulouris^a and Stephen Stuckey^b

^a Department of Radiology, The Alfred Hospital, Prahran, Victoria, Australia
^b Department of Radiology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia

View larger version (116K): [in a new window]   FIG 1. Axial helical CT section (1 mm) obtained through the right petrous temporal bone noteworthy for fluid within the middle ear cleft (arrow) and mastoid air cells (arrowhead).

View larger version (115K): [in a new window]   FIG 2. Axial CT images (1-mm helical sections) through the right petrous temporal bone demonstrating the transcalvarial channels (arrows). Note resolved otomastoiditis (images superior to inferior).

View larger version (126K): [in a new window]   FIG 3. 3D time-of-flight MR angiograms depicting the prominent right occipital artery (arrowhead) and branches permeating through the squamous portion of the occipital bone (arrows), bypassing the previously noted venous stenosis. Note abnormal nonsaturated flow in the dural venous sinus (arrowhead; images superior to inferior).

View larger version (94K): [in a new window]   FIG 4. Selective digital subtraction angiograms of the right external carotid artery (oblique anteroposterior view). Injection of occipital artery (arrowhead) demonstrates transcalvarial channels (arrow) with early venous shunting into the patent dural sinus (asterisk) and ultimately flow into the internal jugular vein (early followed by delayed view).