Endovascular Treatment of Cranial Dural Arterio-Venous Fistulas

Abstract

Intracranial dural arteriovenous fistulas (DAVFs) are relatively rare, acquired, pathologic shunts between dural arteries and dural venous sinuses, meningeal veins, or cortical veins. Signs and symptoms are highly variable and depend upon several factors including fistula location, duration of disease, and venous drainage pattern. The most clinically important feature for classification is venous drainage pattern. Management decisions require a multidisciplinary approach involving discussions among interventional neuroradiologists, neurosurgeons, and neurologists and depend on the type of lesion, including location and angiographic risk strata, assessment of clinical presentation, and patient status (age, comorbidities). Treatment should be pursued for all lesions with cortical venous drainage or intolerable symptoms.