What is a Dural Arteriovenous Fistula (dAVF)?
A dural arteriovenous fistula is a rare vascular malformation in which arteries contained within the dura – a protective layer covering the brain and spinal cord – develop abnormal connections to the veins surrounding the brain or spinal cord.
Symptoms
A dAVF can present with a wide range of symptoms, depending on its location and anatomy. Pulsatile tinnitus, which is a whooshing sound that corresponds to the heart beating, is a common initial symptom. Other symptoms may include headaches, visual disturbance (double vision, bulging of one eye), cognitive deterioration, weakness, numbness, balance difficulty, and changes in bladder and bowel control. In rare cases, dAVFs may cause bleeding in the brain or spinal cord.
Diagnosis
Most dAVFs are initially suspected based on findings on CT or MRI scans. Once a dAVF is identified, or suspected, a neurovascular surgeon is consulted, and a diagnostic angiogram is performed in order to better characterize the location and anatomy of the dAVF.
Treatment Options
All dAVFs require consultation with a neurovascular specialist, however not all dAVFs need to be treated. Low-risk dAVFs that do not cause disabling symptoms can often be safely observed with surveillance imaging. Depending on the location and the anatomy of the dAVF, treatment may be required, and typically involves endovascular embolization and/or surgery. Whether your dAVF requires treatment, and if so, what is the best treatment plan, is a decision you will make together with your neurovascular surgeon.
How Can We Help You?
The multi-disciplinary team at the Ayer Neuroscience Institute Neurovascular Program offers the full spectrum of care for patients with dAVF, from diagnosis to treatment to lifelong follow up and support. Our experienced team of specialists includes fellowship-trained neurosurgeons, vascular neurologists, neuroradiologists, and subspecialized physician assistants, advanced practice registered nurses, and therapists.