title: Microsurgical treatment of a tentorial galenic dural arteriovenous fistula.
abstract: Tentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemorrhage and multitude of feeders. We describe the case of a 65-year-old male who presented with hemorrhage from a straight sinus and galenic TDAVF. The straight sinus portion of the fistula was obliterated by 3 endovascular treatments and 1 microsurgical treatment. The galenic component of the TDAVF persisted and was approached via a posterior interhemispheric approach in a lateral position. This video demonstrates surgical technique and anatomy associated with this rarely seen dural arteriovenous fistula. The video can be found here: https://youtu.be/iOLzWOabLZ0 .
authors.affiliation: Stanford University Medical Center, Department of Neurosurgery, Stanford, California.
authors.forename: Omar
authors.initials: O
authors.lastname: Choudhri
authors.affiliation: Stanford University Medical Center, Department of Neurosurgery, Stanford, California.
authors.forename: Gary K
authors.initials: GK
authors.lastname: Steinberg
mesh_terms: D000368:Aged; D001921:Brain / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D003392:Cranial Sinuses / Q000601:surgery*; D004388:Dura Mater / Q000098:blood supply / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D008297:Male; D013116:Spinal Cord / Q000601:surgery*
keywords: dural arteriovenous fistula; galenic fistula; microsurgery; supracerebellar infratentorial; tentorial fistula; tentorial incisura; vein of Galen; video