Dural Arteriovenous Fistulae: Endovascular Embolization Indications and Techniques

Cranial dural arteriovenous fistulas (DAVFs) are abnormal dural-based connections between meningeal arteries and venous sinuses, meningeal veins, or cortical veins, without an intermediate capillary network or nidus. They account for 10–15% of aberrant intracranial arteriovenous connections. DAVFs are mostly acquired conditions that occur in middle-aged adults. Lesions in the pediatric population, although rare, are often much more complex and beyond the scope of this chapter. Exact etiology of adult DAVFs remains unknown. An association with venous sinus thrombosis has been found, and hypercoagulable states have therefore been implicated. Thrombosis has also been reported as a consequence of dural arteriovenous shunting. Other provocative factors have been reported, such as trauma, intracranial surgery, and radiation exposure. However, many DAVFs occur without an identifiable cause.