Spontaneous Closure of an Intraosseous Jugular Tubercle Venous Complex Arteriovenous Fistula with a Single Venous Drainage Route Following Diagnostic Cerebral Angiography

Objective Spontaneous closure of dural arteriovenous fistulas (AVFs) has been reported. However, complete spontaneous obliteration of a jugular tubercle venous complex (JTVC)-centered intraosseous AVF appears to be rare. We report a case of a JTVC-centered intraosseous AVF that spontaneously occluded after diagnostic cerebral angiography.Case presentation A 34-year-old man presented with a 6-month history of pulsatile tinnitus. MRA suggested an arteriovenous shunt in the JTVC. DSA revealed an intraosseous AVF with a shunt pouch located within the JTVC, supplied by multiple feeders. The lesion drained exclusively into the posterior condylar vein without direct communication with the internal jugular vein, indicating a single and restricted venous drainage pathway. Immediately after angiography, the patient developed headache and nausea, and the tinnitus resolved. Follow-up MRA at 1 month demonstrated disappearance of the shunt, and repeat angiography confirmed complete obliteration. No recurrence was observed at 6 months.Conclusion This case suggests that a JTVC-centered intraosseous AVF with a single and restricted venous drainage pathway may be prone to spontaneous occlusion. Nevertheless, the natural history of such lesions remains unclear, and changes in symptoms should prompt careful imaging evaluation because they may reflect alterations in venous drainage patterns rather than complete shunt obliteration. Long-term imaging follow-up is essential.