PMC9168364_01
MR angiography at admission showing a high signal in the left jugular bulb (arrow in a). The left subclavian arteriography showing the left subclavian artery (black arrowhead of b) flowing distally (black arrow in b), the left subclavian vein (white arrowhead in c) flowing into the left brachiocephalic vein with the retrograde flow into the left internal jugular vein, the left sigmoid sinus, and transverse sinus, inserting to the confluence, and draining through the right transverse sinus (white arrows in c and d).
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F1
MR angiography showed a high signal in the right transverse sinus, sigmoid sinus, and jugular bulb [Figure 1a], which indicated a suspected dural AVF. The retrograde venous flow was inserted into the confluence and drained through the right IJV [Figures 1b-d].
Duplex ultrasonography before surgery showing regurgitation in the left internal jugular vein (a), and visualizing internal jugular vein valves (arrows in b). IJV: internal jugular vein, CCA: common carotid artery, Sub. V.: subclavian vein, Sub. A.: subclavian artery.
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F2
Retrograde venous flow to the left IJV from the left subclavian vein was revealed using US [Figure 2a]. The left IJV valve was then visualized [Figure 2b].
MR angiography after surgery showing the disappearance of a high signal in the left jugular bulb (arrow).
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F3
Brain MR angiography did not show high-intensity signals in any of the intracranial dural sinuses [Figure 3] with no new lesions in the brain.