CASE 2 — venous sinus coiling
Typical sigmoid sinus fistula. This patient also presented with pulsatile tinnitus.
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Left external carotid injection, showing innumerable occipital feeders, and several middle meningeal ones. This might be construed as a multiple hole fistula, but it is not. The single fistula point is marked by red arrow, onto which middle meningeal branches converge.
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Transvenous coil embolization of the sigmoid sinus. Notice that coil mass is tightest near the fistula, which is completely occluded. A posterior temporal vein drains into the left transverse sinus and retrograde to the right.