Dural Arteriovenous Fistulas: Diagnosis And Treatment

If you have signs or symptoms of a dural arteriovenous fistula (dAVF), your doctor may suggest that you get tested, which could include:

Cross-sectional images from noncontrast head computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used in the first examination (MRI).

CT head scans can reveal both fluid buildup and real bleeding, which can be produced by a dAVF but also occur elsewhere in the brain’s venous system.

MRIs can be used to evaluate the shape and size of a dAVF, as well as to detect any micro-hemorrhages and the impact of any aberrant blood vessel structures associated with the fistula.

The most reliable and conclusive tool for dAVF diagnosis is catheter-based cerebral angiography (also known as digital subtraction angiography). It is necessary for defining:

• How many fistulae are there, and where are they located?

• Anatomy of the external carotid arteries, including any branches that connect them to the dura.

• The structure of a fistula’s blood vessels

• Is there any evidence of cardiovascular disease?

• How much has the dural sinus narrowed or become blocked?

• Check to see if any of the afflicted veins are dilated, and if so, how much.

The area of confluence of the feeding dural arteries and the source of the draining vein may also require using angiography to be identified.

Treatment

• Procedures involving the endoscope. Your doctor may use X-ray imaging to guide a long, thin tube (catheter) into a blood vessel in your leg or groyne and thread it through blood vessels to the dural arteriovenous fistula.
• The catheter is inserted into the blood vessel leading to the dAVF, and coils or an adhesive substance are released to block the aberrant blood vessel link.
• Stereotactic radiosurgery is a type of radiosurgery in which the patient is guided through the Your doctor will utilise stereotactic radiosurgery to block the aberrant blood vessel link by using precisely focused radiation.
• Surgery. The dAVF may be disconnected surgically by your surgeon.

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