title: Diagnosis and management of dural arteriovenous fistulas: a 10 years single-center experience.
abstract: OBJECTIVE
  Dural arteriovenous fistulas (DAVFs) are a challenging condition in vascular neurosurgery. Disease natural history and its management is still debated. In the present paper we report our center series on DAVFs over a period of 10 years. Our data were compared with relevant literature.
  
  
  METHODS
  Our series includes 45 cases: 14 cavernous sinus, 11 transverse-sigmoid, 8 patients tentorial, 6 anterior cranial fossa, 5 patients spinal, 1 patient foramen magnum.
  
  
  CONCLUSIONS
  DVAFs distribution, clinical presentation and hemorrhagic risk are discussed. Cavernous sinus DAVFs are the most common site in our series. Other locations in order of frequency are transverse-sigmoid sinus, tentorial, anterior cranial fossa, spinal and foramen magnum. The majority of patients presented with non-aggressive symptoms. 18% presented with intracranial hemorrhage: all the hemorrhages occurred in high-grade DAVFs. For most patients, endovascular treatment, transarterial or transvenous, was the first option. Surgery was performed for the anterior cranial fossa DAVFs and other complex lesions draining mostly transverse-sigmoid sinus and tentorium. In 7% of cases a combination of endovascular+surgical treatment was used. Our series has been carefully analyzed in comparison 'side by side' with most relevant literature on DVAFs, focusing particularly on management strategies, therapeutic options and risks related to treatment.
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Signorelli
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy. Electronic address: gdellapepa@hotmail.com.
authors.forename: G M
authors.initials: GM
authors.lastname: Della Pepa
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sabatino
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Marchese
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Maira
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Puca
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Albanese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000628:therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cortical venous drainage; DAVF; Dural arteriovenous fistulas; Embolization; Hemorrhage; Intracranial dural arteriovenous fistula; Surgery