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AJNR - American Journal of Neuroradiology

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Upper Extremity Arteriovenous Dialysis Fistula Resulting in Cavernous Sinus Arterialized Blood Flow

R.R. Watson^a and C. Russo^a

^a From Clinical Radiologists, SC, Southern Illinois University School of Medicine, Department of Radiology, Memorial Medical Center, Springfield, Ill

View larger version (59K): [in this window] [in a new window]   Fig 1. A, Axial MRA maximum intensity projection (MIP) (TR, 34; TE, 4) shows signal intensity within the left cavernous sinus, petrosal sinus, and transverse sinus. B, Digital subtraction lateral angiogram with selective injection of left internal carotid artery. There is no evidence of venous flow, but there is some reflux into the external carotid artery. C, Conventional angiogram, late arterial phase, shows early filling of left subclavian vein (large arrow) due to ipsilateral AV fistula and retrograde flow in the left jugular vein (with the left common carotid artery superimposed) (small arrow).

View larger version (120K): [in this window] [in a new window]   Fig 2. A 5-month follow-up axial MRA MIP (TR, 50; TE, 6.9) shows no abnormal signal intensity in the cavernous sinus or petrosal sinus. There is a small amount of increased signal intensity in the left transverse sinus (arrow).