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Figure 1: Pre-GKS imaging of a 16-year-old female who presented with left-sided pulsatile tinnitus. Axial T1w + C MR (a), MRA (b), DSA left ECA (c), left ICA AP (d), left ICA lateral (e), and left VA (f) injections reveal a left transverse-sigmoid junction DAVF (white arrow) with feeders from left middle meningeal, left occipital, bilateral meningohypophyseal trunk, and posterior meningeal branch of left vertebral artery

Figure 1:  Pre-GKS imaging of a 16-year-old female who presented with left-sided pulsatile tinnitus. Axial T1w + C MR (a), MRA (b), DSA left ECA (c), left ICA AP (d), left ICA lateral (e), and left VA (f) injections reveal a left transverse-sigmoid junction DAVF (white arrow) with feeders from left middle meningeal, left occipital, bilateral meningohypophyseal trunk, and posterior meningeal branch of left vertebral artery