Neurosurgery for Cranial Dural Arteriovenous Fistulas Dural arteriovenous fistulae (DAVF)

Dural arteriovenous fistulae (DAVFs) are a subset of vascular lesions comprising 10–15 % of all cerebral vascular malformations. They are high-flow, low-resistance connections between a dural artery (or arteries) and a venous sinus or cortical vein. The fistulae lead to venous hypertension, creating ischemic conditions that can trigger a cascade of angiogenesis encouraging fistulous development in a vicious cycle. Cortical venous drainage of DAVFs increases their risk of hemorrhage or leads to nonhemorrhagic neurological deficits and necessitates treatment. DAVFs are treated most commonly through endovascular approaches, but some lesions are better treated with open surgical disconnection.