{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:06:41Z","timestamp":1788977201705,"version":"build-2803163510"},"reference-count":4,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2026,8,22]]},"abstract":"<jats:p>Cerebrospinal fluid (CSF)\u2013venous fistulas are an increasingly recognized source of spontaneous intracranial hypotension, for which endovascular embolization has emerged as an effective treatment option.1\u20133 Advances in diagnostic imaging have improved detection of CSF\u2013venous fistulas throughout the cervical, thoracic, and lumbar spine; however, identification of lesions at the cranial and caudal extremes of the spine remains challenging.4 In video 1, we present the novel case of an anterior condylar confluence CSF\u2013venous fistula arising from a hypoglossal canal nerve root sleeve diverticulum. We demonstrate the diagnostic evaluation, preprocedural planning, and transvenous embolization of the fistula using the pressure cooker technique, highlighting key technical considerations for navigating this uncommon venous anatomy. Finally, we review the patient\u2019s postprocedural course and imaging findings demonstrating radiographic resolution of spontaneous intracranial hypotension.<\/jats:p>\n                  <jats:p>\n                    <jats:fig position=\"float\" id=\"V1\" orientation=\"portrait\">\n                      <jats:label>Video 1<\/jats:label>\n                      <jats:caption>\n                        <jats:title>Endovascular embolization of a cerebrospinal fluid\u2013venous fistula arising from a hypoglossal canal nerve root sleeve diverticulum using a transvenous pressure cooker technique.<\/jats:title>\n                      <\/jats:caption>\n                      <jats:media xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:role=\"media-player-id\" xlink:href=\"BMJ Journals Video Player\" id=\"media1\" mimetype=\"application\" mime-subtype=\"mp4\" content-type=\"play-in-place height-270 width-480\" position=\"float\" orientation=\"portrait\"\/>\n                    <\/jats:fig>\n                  <\/jats:p>","DOI":"10.1136\/jnis-2026-026136","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:20:25Z","timestamp":1788974425000},"page":"jnis-2026-026136","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Endovascular treatment of an anterior condylar confluence cerebrospinal fluid\u2013venous fistula"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0005-5023","authenticated-orcid":false,"given":"Derick","family":"Bunn","sequence":"first","affiliation":[{"name":"Radiology, Mayo Clinic in Florida, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[{"name":"Mayo Clinic Minnesota, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vin Shen","family":"Ban","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Rutgers Health, Newark, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Madhavan","sequence":"additional","affiliation":[{"name":"Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Fermo","sequence":"additional","affiliation":[{"name":"Neurology, Mayo Clinic in Florida, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thien J","family":"Huynh","sequence":"additional","affiliation":[{"name":"Radiology, Mayo Clinic Hospital Jacksonville, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026090910201940000_jnis-2026-026136v1.1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7014"},{"key":"2026090910201940000_jnis-2026-026136v1.2","doi-asserted-by":"crossref","DOI":"10.1136\/neurintsurg-2022-019005","article-title":"Dual microcatheter and coil\/balloon pressure cooker technique for transvenous embolization of cerebrospinal fluid-venous fistulas","volume":"15","author":"Parizadeh","year":"2023","journal-title":"J Neurointerv Surg"},{"key":"2026090910201940000_jnis-2026-026136v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2022-019946"},{"key":"2026090910201940000_jnis-2026-026136v1.4","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A9058"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnis-2026-026136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:20:26Z","timestamp":1788974426000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/jnis-2026-026136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":4,"alternative-id":["10.1136\/jnis-2026-026136"],"URL":"https:\/\/doi.org\/10.1136\/jnis-2026-026136","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]}}}