LAUSR

A 63-year-old, previously healthy, man presented with slowly progressive left eye pain and diplopia. The physical examination revealed a swollen, red left eye, with marked conjunctival inflammation and ipsilateral sixth nerve palsy (figure 1A). Intraocular pressure was 35 mm Hg, and an ocular fluorescein angiography revealed a severe ingurgitation in the left superior ophthalmic vein. Cerebral subtraction angiography revealed a complex left transverse sinus fistula supplied by multiple dural branches and retrograde drainage to the cavernous sinus and superior ophthalmic vein (figure 2). Complete closure of the fistula was achieved with an embolic agent, leading to resolution of the neuro-ophthalmologic syndrome (figure 1B).