Symptomatic jugular venous reflux with dilatation of the superior ophthalmic vein mimicking cavernous dural arteriovenous fistula

Abstract

We report a case of symptomatic jugular venous reflux (JVR) with dilatation of left superior ophthalmic vein (SOV), mimicking cavernous dural arteriovenous fistula (AVF). Severe JVR was caused by an AVFfor hemodialysis access and the narrowing of the left brachiocephalic vein. In-flow signals were found from the left internal jugular vein to left SOV on magnetic resonance angiography, and T1-weighted image and T2-weighted images demonstrated flow voids in bilateral sigmoid sinuses and confluence of sinuses due to rapid retrograde venous flow. We would like to emphasize that the presence of in-flow signals/flow voids in the venous sinuses may be the key imaging clues to distinguish JVR with dilatation of the SOV from cDAVF. Keywords: Jugular venous reflux (JVR), Cavernous dural arteriovenous fistula (cDAVF), Superior ophthalmic vein, MRI, MRA