Dural arteriovenous fistula around the anterior condylar confluent: Report of two cases

Objective: Two cases of dural arteriovenous fistula (DAVF) around the anterior condylar confluent (ACC) were treated with endovascular techniques and are described here. Case presentation: Case 1. A 68-year-old woman presented with an audible pulse-synchronous bruit. Angiogram showed DAVF fed by the ascending pharyngeal artery (APA) and occipital artery (OA) with retrograde drainage to the inferior petrosal sinus. The patient was successfully treated with transvenous coil embolization. Case 2. A 26-year-old man presented with an audible pulse-synchronous bruit. A CT scan indicated enlargement of the posterior condylar canal with marked erosion. Angiogram showed a venous pouch: the posterior condylar vein as the fistulous points fed by the APA and the OA. The patient was successfully treated with transvenous and transarterial coil embolization. Conclusion: DAVF around the ACC is relatively rare. It is therefore important to assess the venous anatomy and the fistulous points for a safe and effective treatment.