ArticleRadiology case reports2026
Endovascular treatment of an intraosseous dural arteriovenous fistula of the greater wing of the sphenoid: A case report and literature review.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Intraosseous dural arteriovenous fistula (DAVF) of the greater wing of the sphenoid is extremely rare, and its endovascular treatment faces challenges due to numerous transosseous feeders and inaccessible dural sinuses. A successful case of transarterial embolization (TAE) is reported. A 63-year-old female presented with headache but no positive neurological signs. Computed tomography and computed tomography angiography revealed left temporal lobe edema and dilated intracranial veins. Digital subtraction angiography confirmed a left intraosseous DAVF of the greater wing of the sphenoid (Cognard type IV), supplied by the dural branch of the right internal carotid artery, the lateral clival artery of the left internal carotid artery, the recurrent meningeal branch of the left ophthalmic artery, the left middle meningeal artery, and transosseous branches from the left internal maxillary artery. Venous drainage occurred via the middle cerebral vein into the veins of Trolard and Labbé and contralateral veins. The DAVF was obliterated through the internal maxillary artery terminal branch and the middle meningeal artery by casting Onyx. Post-endovascular treatment, the patient developed facial numbness. After oral administration of Methycobal 0.5 mg, she showed significant improvement at the 1-month follow-up. At the 3-month follow-up, she recovered well. A PubMed literature review identified 10 reported cases of such DAVFs. It was found that for DAVFs of the greater wing of the sphenoid without an accessible transvenous route, TAE is required. While TAE can achieve obliteration of intraosseous DAVFs of the greater wing of the sphenoid, associated complications cannot be overlooked.
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