title: Diagnosis and management of intracranial dural arteriovenous fistulas.
abstract: Dural arteriovenous fistula (DAVF) is a rare type of acquired intracranial vascular malformation. Recent progress in neuroimaging technology, such as advanced MRI and CT, provides non-invasive methods to accurately diagnose DAVF, including evaluation of the hemodynamics of the drainage veins. The clinical manifestations of DAVFs vary widely and depend on the location and venous drainage pattern of arteriovenous shunting. Patients with high grade DAVFs having cortical venous reflux should receive aggressive treatment to prevent the occurrence of intracranial hemorrhage and other neurological deficits related to venous congestion. Intra-arterial or intravenous endovascular embolization remains the primary therapy for high grade DAVF, while open surgery and stereotactic radiosurgery can serve as alternative treatment options. Early and accurate diagnosis with appropriate treatment is the goal for clinical management of DAVFs to reduce symptoms and prevent the development of venous congestion and stroke.
authors.affiliation: a Department of Neurology and Stroke Center , National Taiwan University Hospital , Taipei , Taiwan.
authors.forename: Li-Kai
authors.initials: LK
authors.lastname: Tsai
authors.affiliation: b Department of Medical Imaging , National Taiwan University Hospital , Taipei , Taiwan.
authors.forename: Hon-Man
authors.initials: HM
authors.lastname: Liu
authors.affiliation: a Department of Neurology and Stroke Center , National Taiwan University Hospital , Taipei , Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
mesh_terms: D001921:Brain / Q000473:pathology*; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D059906:Neuroimaging / Q000379:methods
keywords: cerebral veno-sinus thrombosis; dural arteriovenous fistula; embolization; intracranial hemorrhage; stroke; venous infarct