DAVF (Dural AV Fistula)
- Vascular malformation from pathologic shunts between dural arteries and dural venous sinuses, meningeal veins, and/or cortical veins
– Acquired: previous surgery, trauma, or venous sinus thrombosis
- Pathogenesis: Increased venous flow leads to venous congestion and hypertension, resultant edema, venous ectasia, and (most catastrophically) intracranial hemorrhage
- May present with a range of symptoms depending on location of lesion (i.e., pulsatile tinnitus, ophthalmoplegia). Symptoms of ICB can also present.
Tortuous cortical vein in DAVF (tortuous vessels running along cortex)
– Conservative approach with serial imaging for low-grade fistulas (no cortical venous drainage).- Endovascular embolization is the preferred therapy for lesions requiring treatment