Dural arteriovenous fistula (DAVF) may be associated with trigeminal neuralgia. These
complex malformations in the posterior fossa are known for their intricate arterial
supply and retrograde venous drainage patterns. When trans-arterial endovascular treatment
is unsuccessful, surgical clip ligation can be successfully performed. In this case,
a retrosigmoid keyhole craniotomy and solely endoscopic visualization prove advantageous
for treating this petrosal DAVF, including for managing intraoperative rupture, with
good resolution of the clinical symptoms.
