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Introduction We hereby report a complication that followed an angiographically successful embolisation of a DAVF of the Galenic system.A 70-year-old male presented with altered sensorium and headaches of 3 months duration. Past history included a staged embolisation for a vein of Galen DAVF performed elsewhere, 7 years back. The CT brain, done on admission showed hydrocephalus and acomplex vascular lesion. An EVD was inserted to address the hydrocephalus. It did not improve cognitive dysfunctionAbstract C77 Figure 1Case Description Angiography demonstrated a Cognard 2a+b DAVF with a large venous pouch in the region of the Vein of Galen receiving direct shunts from several meningeal feeders. There was extensive retrograde flow with the straight sinus occluded from previous embolisation. This venous pouch was dysfunctional and did not contribute to venous drainage of the brain. As per a multidisciplinary discussion, it was decided to embolised the DAVF assuming it as the culprit for his cognitive decline as well as to address the risk of bleeding. A transarterial embolisation was performed with complete occlusion of the DAVF. Post embolisation, he was drowsy. CT brain showed fresh intraventricular blood, although there were no detectable intra-procedure events. Hence, the planned anticoagulation was withheld for a day. By next evening the patient started developing diffuse cerebral edema followed by a cascade of events that led to his demise over the next few days.Abstract C77 Figure 2Conclusions We intend to discuss the presumed causes for thIS unfortunate sequence of events and how the disease could have been handled differently.Abstract C77 Figure 3Conflict of Interest Yes CoI for last 2 years: Have received financial renumeration for delivering lectures, proctoring and conducting workshops from Balt, Medtronic, Stryker, Penumbra and BD