Introduction Dural arteriovenous fistula (DAVF) is rare entity disease accounting approximately 1.5 per 1,000,000 persons per year. Transverse-sigmoid and cavernous sinuses is most involving site along all DAVF. While DAVF involving pure isolated sigmoid sinus which is extreme rare and this type have limited to treat by transfemoral, along opposite transverse sinus, transvenous embolization.

Case Presentation A 69-year-old woman with asymptomatic Borden III/ Cognard III DAVF involving the isolated sigmoid sinus underwent staged operation that open surgery using navigation system for exposure sigmoid sinus in operation room and transfer to angiosuite for transvenous embolization.

Conclusion Various modalities were introduced for treating DAVF including surgical disconnection, transarterial, transvenous embolization, stereotactic radiosurgery. However isolated sinus has limitation for treatment because of accessible route. Direct sinus cannulation and transvenous embolization can be most effective method for DAVF involving isolated sinus.

Disclosure of Interest The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper