Ruptured venous aneurysm associated with a dural arteriovenous fistula: Two case reports

Figure 2 Images of case 2. A and B: Axial computed tomography and magnetic resonance angiography (MRA), 18 months before admission, shows intracerebral hemorrhage in the right occipital lobe, and there is an aneurysmal lesion within the hemorrhage; C and D: At admission, MRA shows slightly enlarged previous aneurysmal lesion, and this lesion was supplied by a right occipital artery with dilated internal cerebral vein suggesting dural arteriovenous fistula (dAVF) (white arrowheads); E and F: Right antero-posterior and lateral external carotid artery angiogram shows the dAVF with venous aneurysm fed by the right occipital artery and drained to internal cerebral vein and superior sagittal sinus. There is no definite evidence of venous ectasia or obstruction in the venous outlet; G: A rotational 3-dimensional imaging demonstrates a significant curve and stenosis immediately distal to the aneurysm (white arrows); H: Transarterial embolization with histoacryl (mixed with lipiodol) was performed, and the final angiogram showed complete obliteration of the fistula.