Dural arteriovenous fistulae (DAVF) are rare, abnormal connections between arteries and veins in a protective membrane on the outer layer of the brain and spine, called the dura. These abnormal blood vessels divert blood from the normal paths. If the volume of diverted blood flow is large, tissue downstream may not receive an adequate blood and oxygen supply.
An unusually heavy blood flow also can lead to aneurysms or ruptures in the veins.
This condition can be caused by head trauma, infection, surgery or blood clots in the brain, called thrombosis, or may be a congenital or birth defect.
DAVFs are part of a group of conditions called arteriovenous malformations (AVM). Some fistulas are life-threatening and may cause headaches, seizures or strokes, if they rupture. Others are benign and go undetected until discovered during treatment for other conditions.
At UCSF Medical Center, our Neurovascular Disease and Stroke Center is one of the world's leaders in diagnosing and treating these fistulaes. Our team includes neurologists, neurosurgeons and neuroradiologists who are experts in identifying DAVFs and designing the best possible treatment, including minimally invasive surgical techniques.
The symptoms of dural arteriovenous fistulae (DAVF) can vary widely, depending on the location of the fistulae. Some DAVFs have no symptoms at all and aren't discovered until patients are evaluated for other neurological or vascular conditions.
Some of the common symptoms include:
The following tests may be used to diagnose your dural arteriovenous fistulae (DAVF) and help identify its size, location and blood-flow pattern.
Treatment for dural arteriovenous fistulae (DAVF) depends on the blood vessels involved. Endovascular techniques, which are minimally invasive procedures that are performed through the blood vessels, have been developed to safely treat DAVFs.
An approach, called embolization, reduces blood flow to the DAVF by obstructing surrounding blood vessels. During this procedure, the DAVF is filled with specially designed coils, glues or spheres that plug the vessels.
Some fistulas can't be completely blocked with embolization and may require surgery to disconnect or close them. In some cases, doctors may try to close the fistula with what's called stereotactic radiosurgery or the Gamma Knife.
Reviewed by health care specialists at UCSF Medical Center.