Surgical management of cerebral dural arteriovenous fistulas

Abstract

With the myriad dural arteriovenous fistula (dAVF) locations and evolving treatment paradigms, a multidisciplinary approach incorporating surgical treatment, transarterial embolization, transvenous embolization, or a combination can be ideal. With any treatment modality, the disconnection of the cortical venous reflux eliminates the risk of potentially harmful clinical events and, in some instances, may carry less morbidity than complete excision of the lesion. In this chapter, we discuss the approach to management of dAVFs with specific consideration of the lesions where open surgical strategies can be used for primary treatment or to supplement endovascular treatments.