Brain Health:


Dural Arterio-Venous Fistula (DAVFs)

  • A dural arteriovenous fistula (DAVF) is an abnormal connection between the arteries that normally supply the covering of the brain and veins.
  • DAVFs usually develop in adulthood and can cause symptoms of pulsatile noise, headache, hemorrhage, stroke, or seizure.
  • The treatment of DAVFs may include surgery, embolization or radiosurgery.

A dural arteriovenous fistula (DAVF) results when the blood vessels that normally supply the scalp and coverings of the brain (dura mater) have an abnormal direct connection to veins that carry blood away from the brain. This represents a short circuit that results in abnormally high flow within the brain veins. The two main types of DAVFs are differentiated by whether or not the short circuit results in backwards flow and congestion into veins that lead away from the brain tissue.

The presence or absence of this backflow into normal veins is determined by performing a test call an angiogram in which a tube called a catheter is inserted into the groin and threaded up through the artery in question. X-ray dye is injected through the catheter and X-ray images are recorded. If there is no backwards flow, treatment generally is not recommended because there is virtually no risk of stroke or bleeding into the brain. However, the risk of bleeding, stroke or death is high if backflow is detected. In these cases, treatment is highly recommended.

There are two chief ways of treating DAVFs. Surgery can be performed in which the surgeon makes an incision and disconnects the abnormal short circuit. Another method of treatment is embolization in which the doctor places a tiny catheter into the site of the short circuit and blocks it by injecting metal coils, liquid adhesives or tiny plastic particles.