Diagnosis and management of dural arteriovenous fistulas: A 10 years single-center experience

F. Signorelli, G. M. Della Pepa, G. Sabatino, E. Marchese, G. Maira, A. Puca, A. Albanese

Research output: Contribution to journalArticle

Abstract

Objectives Dural arteriovenous fistulas (DAVFs) are a challenging condition in vascular neurosurgery. Disease natural history and its management is still debated. In the present paper we report our center series on DAVFs over a period of 10 years. Our data were compared with relevant literature. Patient and methods Our series includes 45 cases: 14 cavernous sinus, 11 transverse-sigmoid, 8 patients tentorial, 6 anterior cranial fossa, 5 patients spinal, 1 patient foramen magnum. Results and conclusions DVAFs distribution, clinical presentation and hemorrhagic risk are discussed. Cavernous sinus DAVFs are the most common site in our series. Other locations in order of frequency are transverse-sigmoid sinus, tentorial, anterior cranial fossa, spinal and foramen magnum. The majority of patients presented with non-aggressive symptoms. 18% presented with intracranial hemorrhage: all the hemorrhages occurred in high-grade DAVFs. For most patients, endovascular treatment, transarterial or transvenous, was the first option. Surgery was performed for the anterior cranial fossa DAVFs and other complex lesions draining mostly transverse-sigmoid sinus and tentorium. In 7% of cases a combination of endovascular + surgical treatment was used. Our series has been carefully analyzed in comparison 'side by side' with most relevant literature on DVAFs, focusing particularly on management strategies, therapeutic options and risks related to treatment.

Original languageEnglish
Pages (from-to)123-129
Number of pages7
JournalClinical Neurology and Neurosurgery
Volume128
DOIs
Publication statusPublished - 2015

Keywords

  • DAVF
  • Dural arteriovenous fistulas
  • Embolization
  • Hemorrhage/Cortical venous drainage
  • Intracranial dural arteriovenous fistula
  • Surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

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