https://doi.org/10.46889/JNOR.2023. https://athenaeumpub.com/journal-of-neuro-and-oncology-research/ Case Report Diagnosis and Minimally-Invasive Treatment of Posterior Fossa Dural Arteriovenous Fistula Presenting Clinically as A Carotid- Cavernous Fistula Oktay Algin 1* 1 Ankara University, Medical Faculty, Department of Radiology, Ankara, Türkiye 2 National MR Research Center (UMRAM), Bilkent University, Ankara, Türkiye 3 Interventional MR Clinical R&D Center, Ankara University, Ankara, Türkiye *Correspondence author: Prof. Oktay Algin, MD, Interventional MR Clinical R and D Center, Ankara University, Ankara, Türkiye; Email: oktay.algin@umram.bilkent.edu.tr Abstract A posterior fossa dural arteriovenous fistula presenting clinically as a carotid-cavernous fistula is a very rare and relatively unknown situation. They present with several clinical symptoms due to abnormal or excessive blood flowing into the cavernous sinuses. Although abnormal shunts between two vascular domains near each other may be expected (as in carotid-cavernous fistulas), an abnormal shunt from a distant artery to a cavernous venous sinus would be something unusual. Endovascular treatment is now the first-line, safest and cost-effective treatment for this type of fistula. In this paper, we report a very rare situation (a spontaneous posterior fossa dural arteriovenous fistula presenting clinically as a carotid-cavernous fistula) that is treated with endovenous intervention and coil embolization. The importance of other cavernous sinus-related fistulas, their diagnostic features and therapeutic options will also be discussed in this paper. Keywords: Carotid Cavernous Fistula; Embolization; Imaging; Endovascular Treatment; Dural Arteriovenous Fistula; Inferior Petrosal Sinus Introduction Carotid-Cavernous Fistulas (CCFs) are well-known abnormal vascular shunts with direct or indirect abnormal blood flow from the cavernous carotid artery to venous sinuses [1]. It usually presents with ophthalmic symptoms. Anterior venous drainage in a dural Arteriovenous Fistula (dAVF) causes ocular symptoms, tinnitus, and/or pain similar to CCF. Endovascular treatment is the best treatment modality of choice in these cases [1]. In this paper, we report a case with a non-traumatic dAVF which was treated by an endovenous intervention. The importance of cavernous sinus-related fistulas, as well as their imaging features and therapeutic options, are also discussed in this manuscript. Case Report Fifty-seven-year-old female complaining of progressive chemosis, retro-orbital headache, proptosis and blurred vision over the last 3 weeks was referred to our ophthalmology department. Physical examination revealed limited eye movements, scleral congestion, secondary glaucoma and a dilated pupil with optic disc swelling on the left side. A bruit over the left superior orbital rim was also noted. There was no history of trauma, medication or familial/concomitant disease. She was then referred to our radiology department for head CT Angiography (CTA), with suspicion of spontaneous CCF. Citation: Algin O. Diagnosis and Minimally-Invasive Treatment of Posterior Fossa Dural Arteriovenous Fistula Presenting Clinically as A Carotid-Cavernous Fistula. J Neuro Onco Res. 2023;3(3):1-5. https://doi.org/10.46889/JNOR.2023. Received Date: 11-12-2023 Accepted Date: 25-12-2023 Published Date: 31-12-2023 Copyright: © 2023 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CCBY) license (https://creativecommons.org/li censes/by/4.0/).