Neurology: Misdiagnosed as CLIPPERS venous fistula

63 years old, male, chronic right headache and intermittent nausea, C2-3 vertebral excisionFour years ago, he began to get dizzy when he got up and resemmeed when you lay downTwo years ago, balance barriers were discovered and there were several fallsSix months ago, I was sick for a week and was dizzy and couldn't get out of bedThe symptoms subsided on his own, but since then he has woken up with mild nausea and dizziness every dayHypertension, asthma and obstructive sleep apneathis time because of the increased headache, nausea and has been vomitingthe symptoms of the hospital after the aggravation of symptoms, left gaze when re-looking, weak limbs, confusionFigures A and B, shaft-level MRI shows the bridge brain Flair high signal, accompanied by patchy reinforcementC graph, the ascalding of the taper T1 shows the strengthening of the lower part of the bridge brain, myelin and the leukoid (hence the diagnosis of CLIPPERS and hormone therapy)At the same time can be seen thickening the bridge brain extension of the myelin pre-venous vein, can be distinguished from the base artery, the latter more forward (rough arrow)D figure, axis SWI shows the two-sided cerebellum membrane vein squeavent, to the right more noticeable (arrow)Some micro-bleeding can be seen in the cerebellum and brain stem:E, DSA shows the stem of the meninge pituitary body thickening, starting from the end of the sinuses of the artery in the neck, the change in diameter (arrow) conforms to the right-hand ionic epidural venous fistulaFigure f and G, the vein blood flow down, to the rock vein and bridge extension vein (arrow), all the way down to the upper thoracic spine H, intravascular closed epidural igolastic fistula, right within the carotid algectoric, fistula completely disappears I, one month later, Flair shows that bridge brain lesions have largely disappeared: