Type V tentorial dural arteriovenous fistula: a case of augmented reality-assisted surgical salvage.

This video demonstrates the case of a Cognard type V tentorial dural arteriovenous fistula that was successfully salvaged using augmented reality-assisted microsurgery following failed endovascular embolization. The patient had a spastic gait and quadrilateral numbness. MRI showed medullary edema and abnormal vessels near the tentorium. DSA confirmed a shunt fed by the meningohypophyseal trunk draining into perimedullary veins. Initial embolization was unsuccessful. Using CISS MRI and augmented reality projection, the authors identified and ligated the arterialized veins, relieving venous hypertension. Postoperative imaging showed improvement of the brainstem edema. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2541.