Background and purpose: The treatment of a dural arteriovenous fistula (DAVF) can involve surgery, radiosurgery, or endovascular embolization. New embolization techniques and agents have expanded the role of endovascular treatment.
Methods: We report the endovascular embolization with Onyx-18 of a DAVF fed by the posterior auricular artery.
Results: The DAVF was successfully embolized; however, the patient's ear developed ischemic necrosis of the superolateral pinna.
Conclusions: Onyx-18 can provide high rates of success in the treatment of DAVFs in well-selected patients. Risks of end organ ischemia must be considered during endovascular embolization and when counseling patients regarding procedural risk.