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A dural arteriovenous fistula of the right cavernous sinus is seen, supplied mainly by multiple branches of the right internal maxillary artery, including several branches arising from the middle meningeal artery, the accessory meningeal artery, and the artery of the foramen rotundum. There is additional supply to the fistula in the right cavernous sinus arising from the meningo hypophyseal branches of the internal carotid arteries bilaterally.
The right sided fistula drains to the right SOV directly, and to the left SOV via a transsellar anastomosis. The inferior petrosal sinuses are thrombosed bilaterally.