Türk Nöroşirürji Dergisi 2021 , Vol 31 , Num 2
Dural Arteriovenous Fistulas: Natural History, Clinical Presentations and Indications for Treatment
Ahmet ÖZAK1,Ethem T. GÖKSU1
1Akdeniz Üniversitesi Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Antalya, Türkiye Intracranial dural arteriovenous fistulas (DAVF) represent 10 - 15% of all intracranial vascular malformations. These fistulas are from the meningeal vessels to the dural venous sinuses or cortical veins. They can occur anywhere within the intracranial duramater, frequently at the transverse - sigmoid junction but also at the cavernous sinus, superior sagittal sinus, anterior cranial fossa, tentorium, and other locations. Venous hypertension is thought to play a critical role in the pathogenesis. Various classification systems have been proposed, including venous drainage patterns and clinical features. Patients may be asymptomatic or may present in a wide clinical spectrum, ranging from mild symptoms to fatal hemorrhage depending on the location and venous drainage pattern of the lesion. The presence of cortical venous drainage and a posterior fossa location seem to be independent risk factors for hemorrhage. Treatment strategies include observation, stereotactic radiosurgery, endovascular interventions, and surgery. The location of the lesion, and the clinical and angiographic features should be considered for decision making. Anahtar Kelimeler : Dural arteriovenous fistulas, Natural history, Treatment