Dural Arteriovenous Fistulas

Diagnosis

If your healthcare professional suspects a dural arteriovenous fistula (dAVF), several imaging tests may be used to confirm the diagnosis and evaluate the extent of the condition. These tests help identify irregular connections between arteries and veins in the dura mater of the brain.

Common diagnostic tests include:

• CT scans to detect fluid buildup, bleeding, or signs of increased pressure in the brain.

• MRI scans to reveal the structure and location of the fistula and identify small bleeds or swelling caused by abnormal vessels.

• Cerebral angiography (digital subtraction angiography), a catheter-based imaging test that provides detailed information about:

  • The number and location of fistulae

  • The structure of blood vessels and the dural sinuses

  • The degree of narrowing or blockage

  • Any related cardiovascular disease

Cerebral angiography remains the most accurate and essential tool for diagnosing dAVF and planning treatment.

Treatment

Treatment for dural arteriovenous fistula focuses on closing the abnormal connection between arteries and veins to restore normal blood flow and prevent complications. The approach depends on the size, location, and symptoms of the fistula.

Treatment options include:

• Endovascular procedures
  A catheter is inserted through a blood vessel, usually in the leg or groin, and guided to the site of the fistula. Coils or a glue-like material are released to block the abnormal blood vessel connection.

• Stereotactic radiosurgery
  This noninvasive procedure uses precisely targeted radiation to close off the abnormal vessels over time. Technologies such as Gamma Knife, linear accelerator, or proton beam therapy may be used.

• Surgical disconnection
  If endovascular or radiosurgical options aren’t suitable, surgery may be performed to disconnect the fistula or remove the affected portion of the dura to stop abnormal blood flow.

Preparing for Your Appointment

To make the most of your consultation, it helps to prepare ahead of time:

• Keep a record of your symptoms, noting when they occur and how long they last.

• Bring a list of your current medicines, vitamins, or supplements.

• Take a family member or friend to help remember key details.

• Bring any recent imaging scans on CD for review.

• Write down questions to ask your doctor, starting with the most important.

Example questions include:

• Where is the fistula located?

• Will I need follow-up tests, and how often?

• How long is the surgery and recovery time?

• How many dAVFs has your team treated?

What to Expect from Your Doctor

Your healthcare professional may ask questions such as:

• When did your symptoms first appear?

• Have you experienced hearing, vision, speech, or movement issues?

• Are your symptoms constant or do they come and go?

• Do certain activities trigger your symptoms?

What You Can Do in the Meantime

While waiting for evaluation or treatment, you can help reduce risks by:

• Avoiding excessive alcohol and nicotine use

• Getting enough rest

• Managing stress through relaxation techniques

These steps may help minimize seizure risk and support overall brain health while your treatment plan is being developed.