Materiały źródłowe

• #1 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532274/

  Dural arteriovenous fistulas, sometimes referred to as dural arteriovenous malformations, are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. […] This activity outlines how to properly evaluate dural arteriovenous fistulas, and highlights the role of the interprofessional team in caring for patients with this condition. […] The decision of whether to treat dAVFs is based on the patient’s symptoms, medical comorbidities, and risk of intracranial hypertension or hemorrhage. […] Post-treatment, the nurse is vital for monitoring the neurological exam and helping with ambulation and feeding. The nurse also plays a role in educating the patient and family about the disease and the potential adverse effects of treatment. […] An integrated approach with a team of healthcare professionals is recommended to make an early diagnosis and appropriate treatment.

• #2 Updates in the management of cranial dural arteriovenous fistula | Stroke and Vascular Neurology

  https://svn.bmj.com/content/5/1/50

  Dural arteriovenous fistula (dAVF) accounts for approximately 10% of all intracranial vascular malformations. While they can be benign lesions, the presence of retrograde venous drainage and cortical venous reflux makes the natural course of these lesions aggressive high risk of haemorrhage, neurological injury and mortality. Endovascular treatment is often the first line of treatment for dAVF. Both transarterial and transvenous approaches are used to cure dAVF. […] Because of the benign nature, dAVFs without CVR (grades I and II) are often managed conservatively. Treatment can be palliative for patients who suffer from incapacitant tinnitus, ocular symptoms or severe headache. Compression therapy is sometimes used as adjunct treatment for dAVF without CVR. Compression of ipsilateral carotid artery or occipital artery is performed by contralateral hand three times a day.

• #3 Arteriovenous Fistula Survival | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/survival/overview

  A dural arteriovenous fistula (dAVF) is a rare vascular disorder that occurs when there is an abnormal connection between the arteries and veins in the dura mater, the tough outer membrane that covers the brain and spinal cord. This abnormal connection causes blood to flow directly from an artery to a vein, bypassing the normal capillary system. […] Once diagnosed, the treatment goal for a dAVF is to stop the abnormal blood flow, which can be achieved through various surgical or endovascular techniques. The specific approach depends on the fistula’s characteristics and the patient’s overall health. […] Maintaining regular follow-up with your care team is essential for those with dAVFs to ensure stability and address any emerging symptoms. […] Each of these treatments aims to restore normal blood flow, and many patients achieve a cure in that the fistula no longer affects their health or quality of life. However, close monitoring post-treatment is essential to detect any changes or complications early.

• #4 Dural Arteriovenous Fistula (DAVF) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/dural-arteriovenous-fistula-davf

  Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins near the brain. […] These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion. […] While dural arteriovenous fistulas are lesions outside the brain, they may present with a wide range of neurologic symptoms. […] The presentation varies from an asymptomatic state, to ringing or humming in the ear (or pulsatile tinnitus) to life-threatening or fatal bleeding in the brain. […] It is important to tailor management of DAVF to each patient. […] Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient’s symptoms. […] Most dural fistulas can be managed by endovascular means but some are more appropriately approached by surgery. […] Some difficult lesions need the judicious combination of endovascular techniques and surgery.

• #5 Dural Arteriovenous Fistulas | Stanford Health Care

  https://stanfordhealthcare.org/medical-treatments/n/neurointerventional-radiology/conditions-treated/dural-arteriovenous-fistulas.html

  Dural arteriovenous fistulae (AVF) are blood vessels that represent abnormal connections between arteries and veins that are found in the covering of the brain. This covering is known as the dura, hence the name. There is a direct connection between the arteries and the vein without any vessels between. […] These fistulae or abnormal connections usually develop over time and can occur after trauma, infection or thrombosis (clotting-off) of veins in the dura. The fistula may cause abnormal noises in the head due to the high flow of blood. They can also cause headaches or result in bleeding into the brain. […] The treatment is similar to those available for AVMs and can include embolization, surgery, and in some cases radiosurgery. Embolization is often used as the primary therapy to treat this problem. Embolization is performed by placing a tiny catheter directly into the AVF. Embolic material is then injected into the blood vessel to block them up. The embolic material leaves the catheter as liquid and solidifies within the AVF blood vessel to block it up. Sometimes coils are also used to block up the AVF.

• #6 Dural Arteriovenous Fistula (DAVF) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/dural-arteriovenous-fistula-davf

  Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins near the brain. […] These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion. […] While dural arteriovenous fistulas are lesions outside the brain, they may present with a wide range of neurologic symptoms. […] The presentation varies from an asymptomatic state, to ringing or humming in the ear (or pulsatile tinnitus) to life-threatening or fatal bleeding in the brain. […] It is important to tailor management of DAVF to each patient. […] Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient’s symptoms. […] Most dural fistulas can be managed by endovascular means but some are more appropriately approached by surgery. […] Some difficult lesions need the judicious combination of endovascular techniques and surgery.

• #7 Dural Arteriovenous Fistula Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/types/overview

  Dural arteriovenous fistulas (dAVFs) are uncommon, yet significant vascular disorders that occur within the dura mater, the protective membrane that surrounds the brain and spinal cord. […] Treatment options range from conservative monitoring to more aggressive interventions like endovascular embolization or surgical disconnection. […] The seriousness of a fistula depends on its location, type, and venous drainage pattern. dAVFs with cortical venous drainage are considered serious because they carry a higher risk of bleeding. […] Symptoms can range from headaches and ringing in the ears to more severe effects like seizures or hemorrhage. […] When symptoms are present, they should not be ignored, as dAVFs can lead to serious health risks if left untreated. […] Most people with dAVFs are diagnosed after they start experiencing symptoms, which can vary widely depending on the location and severity of the fistula. […] The gold standard for diagnosing dAVFs is a formal angiogram, also known as digital subtraction angiography (DSA). […] Early diagnosis of a dAVF is important to prevent complications such as brain hemorrhage or permanent neurological damage.

• #8 Dural Arteriovenous Fistula Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/types/overview

  Dural arteriovenous fistulas (dAVFs) are uncommon, yet significant vascular disorders that occur within the dura mater, the protective membrane that surrounds the brain and spinal cord. […] Treatment options range from conservative monitoring to more aggressive interventions like endovascular embolization or surgical disconnection. […] The seriousness of a fistula depends on its location, type, and venous drainage pattern. dAVFs with cortical venous drainage are considered serious because they carry a higher risk of bleeding. […] Symptoms can range from headaches and ringing in the ears to more severe effects like seizures or hemorrhage. […] When symptoms are present, they should not be ignored, as dAVFs can lead to serious health risks if left untreated. […] Most people with dAVFs are diagnosed after they start experiencing symptoms, which can vary widely depending on the location and severity of the fistula. […] The gold standard for diagnosing dAVFs is a formal angiogram, also known as digital subtraction angiography (DSA). […] Early diagnosis of a dAVF is important to prevent complications such as brain hemorrhage or permanent neurological damage.

• #9 Dural Arteriovenous Fistula Overview | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/types/overview

  Dural arteriovenous fistulas (dAVFs) are uncommon, yet significant vascular disorders that occur within the dura mater, the protective membrane that surrounds the brain and spinal cord. […] Treatment options range from conservative monitoring to more aggressive interventions like endovascular embolization or surgical disconnection. […] The seriousness of a fistula depends on its location, type, and venous drainage pattern. dAVFs with cortical venous drainage are considered serious because they carry a higher risk of bleeding. […] Symptoms can range from headaches and ringing in the ears to more severe effects like seizures or hemorrhage. […] When symptoms are present, they should not be ignored, as dAVFs can lead to serious health risks if left untreated. […] Most people with dAVFs are diagnosed after they start experiencing symptoms, which can vary widely depending on the location and severity of the fistula. […] The gold standard for diagnosing dAVFs is a formal angiogram, also known as digital subtraction angiography (DSA). […] Early diagnosis of a dAVF is important to prevent complications such as brain hemorrhage or permanent neurological damage.

• #10 A Rare and Treatable Cause of Medullar Claudication: Spinal Dural Arteriovenous Fistula | Ochsner Journal

  https://www.ochsnerjournal.org/content/19/4/397

  Spinal dural arteriovenous fistula is a rare and underdiagnosed disorder. […] Physicians should be aware of the specific abnormalities shown on spinal cord MRI that indicate dural arteriovenous fistula, as well as the criteria for performing medullar angiography, so that the condition can be diagnosed and treated in a timely manner. Early therapeutic treatment is the principal prognosis factor. […] Imaging is crucial to confirm the diagnosis of spinal dural arteriovenous fistula. […] Medullar angiography is the gold standard for diagnosis and must be performed according to specific criteria. […] Once the fistula is visualized, a therapeutic discussion is necessary. Endovascular treatment can be performed by using a liquid agent (glue) to embolize the fistula point. […] After treatment, symptoms generally improve, particularly motor symptoms. Prognosis depends on the level of severity of neurologic disturbance, early diagnosis, and early therapeutic treatment.

• #11 A Rare and Treatable Cause of Medullar Claudication: Spinal Dural Arteriovenous Fistula | Ochsner Journal

  https://www.ochsnerjournal.org/content/19/4/397

  Although dural arteriovenous fistula is the most common spinal vascular malformation, it is still underdiagnosed because of its nonspecific clinical presentation and many physicians lack of knowledge about its specific abnormalities shown on spinal cord MRI. Medullar angiography is the gold standard for diagnosis but must be performed according to strict criteria to identify the abnormality. Early therapeutic treatment is the principal factor affecting prognosis.

• #12 Dural Arteriovenous Fistula Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/dural-arteriovenous-fistula

  A dural arteriovenous fistula (DAVF), also called a dural arteriovenous malformation (dural AVM), is an atypical connection between blood vessels in the dura. When necessary, surgical treatment for DAVF most commonly takes the form of endovascular embolization, microsurgical resection, or stereotactic radiosurgery. […] Dural arteriovenous fistulas are complex lesions and should be managed at major centers with specialists highly trained in their treatment. At Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, our neurosurgeons are experienced in evaluating DAVFs and in treating them surgically when necessary. […] The current treatment of choice for other DAVFs is endovascular embolization. To perform this procedure, a specialist inserts a catheter through an artery in the groin and then guides the catheter through the circulatory system to the site of the DAVF. Once in position, the catheter delivers a kind of glue. The glue embolizes the abnormal passageway, blocking the abnormal connection often permanently curing the fistula.

• #13 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532274/

  Dural arteriovenous fistulas, sometimes referred to as dural arteriovenous malformations, are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. […] This activity outlines how to properly evaluate dural arteriovenous fistulas, and highlights the role of the interprofessional team in caring for patients with this condition. […] The decision of whether to treat dAVFs is based on the patient’s symptoms, medical comorbidities, and risk of intracranial hypertension or hemorrhage. […] Post-treatment, the nurse is vital for monitoring the neurological exam and helping with ambulation and feeding. The nurse also plays a role in educating the patient and family about the disease and the potential adverse effects of treatment. […] An integrated approach with a team of healthcare professionals is recommended to make an early diagnosis and appropriate treatment.

• #14 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532274/

  Dural arteriovenous fistulas, sometimes referred to as dural arteriovenous malformations, are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. […] This activity outlines how to properly evaluate dural arteriovenous fistulas, and highlights the role of the interprofessional team in caring for patients with this condition. […] The decision of whether to treat dAVFs is based on the patient’s symptoms, medical comorbidities, and risk of intracranial hypertension or hemorrhage. […] Post-treatment, the nurse is vital for monitoring the neurological exam and helping with ambulation and feeding. The nurse also plays a role in educating the patient and family about the disease and the potential adverse effects of treatment. […] An integrated approach with a team of healthcare professionals is recommended to make an early diagnosis and appropriate treatment.

• #15 Dural Arteriovenous Fistula (DAVF) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/dural-arteriovenous-fistula-davf

  Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins near the brain. […] These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion. […] While dural arteriovenous fistulas are lesions outside the brain, they may present with a wide range of neurologic symptoms. […] The presentation varies from an asymptomatic state, to ringing or humming in the ear (or pulsatile tinnitus) to life-threatening or fatal bleeding in the brain. […] It is important to tailor management of DAVF to each patient. […] Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient’s symptoms. […] Most dural fistulas can be managed by endovascular means but some are more appropriately approached by surgery. […] Some difficult lesions need the judicious combination of endovascular techniques and surgery.

• #16 Dural Arteriovenous Fistula (DAVF) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/dural-arteriovenous-fistula-davf

  Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins near the brain. […] These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion. […] While dural arteriovenous fistulas are lesions outside the brain, they may present with a wide range of neurologic symptoms. […] The presentation varies from an asymptomatic state, to ringing or humming in the ear (or pulsatile tinnitus) to life-threatening or fatal bleeding in the brain. […] It is important to tailor management of DAVF to each patient. […] Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient’s symptoms. […] Most dural fistulas can be managed by endovascular means but some are more appropriately approached by surgery. […] Some difficult lesions need the judicious combination of endovascular techniques and surgery.

• #17 Arteriovenous Fistula Survival | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/survival/overview

  A dural arteriovenous fistula (dAVF) is a rare vascular disorder that occurs when there is an abnormal connection between the arteries and veins in the dura mater, the tough outer membrane that covers the brain and spinal cord. This abnormal connection causes blood to flow directly from an artery to a vein, bypassing the normal capillary system. […] Once diagnosed, the treatment goal for a dAVF is to stop the abnormal blood flow, which can be achieved through various surgical or endovascular techniques. The specific approach depends on the fistula’s characteristics and the patient’s overall health. […] Maintaining regular follow-up with your care team is essential for those with dAVFs to ensure stability and address any emerging symptoms. […] Each of these treatments aims to restore normal blood flow, and many patients achieve a cure in that the fistula no longer affects their health or quality of life. However, close monitoring post-treatment is essential to detect any changes or complications early.

• #18 Dural Arteriovenous Fistula Treatment Sydney – CURA Medical SpecialistsCURA Specialists

  https://curaspecialists.com.au/conditions/dural-arteriovenous-fistula-treatment-sydney/

  We at CURA Medical Specialists are leading experts in the diagnosis and treatment of DAVFs. Whether youre suffering from low-risk or high-risk DAVFs, we will be able to provide you with a treatment plan for your individual needs to ensure you dont suffer from any further complications. […] Minimally invasive endovascular embolisation and microsurgical resection are two conventional methods for DAVF treatment. One or a combination of the two methods can also be used. […] A catheter is passed through the groin into the arteries that lead to the brain. A liquid embolic agent, such as glue or Onyx is then injected into the affected arteries. This liquid helps to block the artery, reducing the flow of blood through the DAVF. This is the most common treatment and in most cases is enough to treat various types of DAVFs and prevent future risk of haemorrhage.

• #19 Updates in the management of cranial dural arteriovenous fistula | Stroke and Vascular Neurology

  https://svn.bmj.com/content/5/1/50

  Endovascular approach is the first-line treatment for most dAVFs. The mainstay for endovascular treatment involves embolisation of the fistulous connection and its venous components while preventing adverse effects. […] A transarterial approach is the preferred treatment for high-grade dAVFs with direct cortical venous drainage or in cases in which transvenous approach is limited. […] Transvenous approach is preferred when a dAVF is supplied by small tortuous arteries excluding safe transarterial access to fistulous part, when dAVF is only supplied by branches directly from the ICA or vertebral artery, when dAVF is supplied by arteries with dangerous extracranial to intracranial anastomosis, or when the dAVF is supplied by nutrient arteries of cranial nerves. […] While endovascular techniques are often considered first-line therapy for treatment of dAVFs, surgery remains an alternate effective and safe option.

• #20 Dural arteriovenous fistulas – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/diagnosis-treatment/drc-20364281

  Our caring team of Mayo Clinic experts can help you with your dural arteriovenous fistulas-related health concerns […] Treatment for a dural arteriovenous fistula (dAVF) involves a procedure to block or disconnect the fistula. […] Procedures that can treat dAVF include: […] In an endovascular procedure, a long, thin tube called a catheter is inserted into a blood vessel in your leg or groin. It is threaded through blood vessels to the dural arteriovenous fistula using X-ray imaging. Coils or a glue-like substance is released to block the connection in the blood vessels. […] In stereotactic radiosurgery, precisely focused radiation blocks the irregular connection in the blood vessels. This causes blood vessels in the fistula to close off, destroying the dAVF. […] If an endovascular procedure or stereotactic radiosurgery aren’t options for you, you may need dAVF surgery. Surgery may be performed to disconnect the dAVF or cut off the blood supply and remove the fistula. […] Dural arteriovenous fistulas care at Mayo Clinic.

• #21 Lyerly | Neurosurgery | Dural Arteriovenous Fistulas

  https://www.baptistjax.com/doctors/lyerly-neurosurgery/stroke-and-cerebrovascular-care/understanding-dural-arteriovenous-fistulas

  If you’ve been diagnosed with a dural arteriovenous fistula, your doctor will create a treatment plan for you that is based on several factors, including the size and location of the DAVF (together with its potential for hemorrhage), whether there is evidence of past or current bleeding, the severity of your symptoms and your overall health. […] Treatment options for DAVF are designed to close the abnormal connection between its arteries and veins, and include: […] Endovascular embolization is a minimally invasive procedure that does not require open brain surgery. During the procedure, a neurosurgeon threads a small, flexible tube called a catheter through the arteries (often starting in the groin area) until it reaches an artery that „feeds” the DAVF with blood. Once the catheter is in place, the neurosurgeon injects one of several materials called embolizing agents these include tiny metal coils and glue-like substances to reduce or block blood flow into the DAVF.

• #22 Lyerly | Neurosurgery | Dural Arteriovenous Fistulas

  https://www.baptistjax.com/doctors/lyerly-neurosurgery/stroke-and-cerebrovascular-care/understanding-dural-arteriovenous-fistulas

  Conventional or „open” surgery may be used if the DAVF cannot be easily reached with a catheter or successfully blocked with embolizing agents. During the procedure, a neurosurgeon first performs a craniotomy to temporarily remove a piece of the skull and gain access to the brain, then uses surgical tools to seal off and remove the DAVF. […] Radiosurgery uses radiation beams to damage, and eventually close, the blood vessels that make up the DAVF (despite what the name implies, it is not surgery in the traditional sense because the procedure does not require cutting or an incision). During the procedure, multiple beams of radiation are simultaneously aimed at the brain. The beams meet at the DAVF to deliver a single, massive dose of radiation. […] If you or a loved one has been diagnosed with a dural arteriovenous fistula, you’ll find the care and support you need at Lyerly Neurosurgery. In partnership with Baptist Medical Center Jacksonville, our team provides emergency and preventive DAVF treatment, including endovascular embolization by specialists who are fellowship trained in endovascular neurosurgery.

• #23 Dural Arteriovenous Fistula Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/dural-arteriovenous-fistula

  Sometimes microsurgical resection, in which a surgeon completely removes the abnormal vessels, is necessary. When possible, the DAVF lesion is embolized before it is removed. But in cases in which the risk of hemorrhage is high, or in which the catheter cannot reach the DAVF, microsurgical resection may be used alone. […] Stereotactic radiosurgery also may be used in specific cases.

• #24 Dural arteriovenous fistulas – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/diagnosis-treatment/drc-20364281

  Our caring team of Mayo Clinic experts can help you with your dural arteriovenous fistulas-related health concerns […] Treatment for a dural arteriovenous fistula (dAVF) involves a procedure to block or disconnect the fistula. […] Procedures that can treat dAVF include: […] In an endovascular procedure, a long, thin tube called a catheter is inserted into a blood vessel in your leg or groin. It is threaded through blood vessels to the dural arteriovenous fistula using X-ray imaging. Coils or a glue-like substance is released to block the connection in the blood vessels. […] In stereotactic radiosurgery, precisely focused radiation blocks the irregular connection in the blood vessels. This causes blood vessels in the fistula to close off, destroying the dAVF. […] If an endovascular procedure or stereotactic radiosurgery aren’t options for you, you may need dAVF surgery. Surgery may be performed to disconnect the dAVF or cut off the blood supply and remove the fistula. […] Dural arteriovenous fistulas care at Mayo Clinic.

• #25 Lyerly | Neurosurgery | Dural Arteriovenous Fistulas

  https://www.baptistjax.com/doctors/lyerly-neurosurgery/stroke-and-cerebrovascular-care/understanding-dural-arteriovenous-fistulas

  Conventional or „open” surgery may be used if the DAVF cannot be easily reached with a catheter or successfully blocked with embolizing agents. During the procedure, a neurosurgeon first performs a craniotomy to temporarily remove a piece of the skull and gain access to the brain, then uses surgical tools to seal off and remove the DAVF. […] Radiosurgery uses radiation beams to damage, and eventually close, the blood vessels that make up the DAVF (despite what the name implies, it is not surgery in the traditional sense because the procedure does not require cutting or an incision). During the procedure, multiple beams of radiation are simultaneously aimed at the brain. The beams meet at the DAVF to deliver a single, massive dose of radiation. […] If you or a loved one has been diagnosed with a dural arteriovenous fistula, you’ll find the care and support you need at Lyerly Neurosurgery. In partnership with Baptist Medical Center Jacksonville, our team provides emergency and preventive DAVF treatment, including endovascular embolization by specialists who are fellowship trained in endovascular neurosurgery.

• #26 Dural Arteriovenous Fistula (DAVF) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/dural-arteriovenous-fistula-davf

  Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins near the brain. […] These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion. […] While dural arteriovenous fistulas are lesions outside the brain, they may present with a wide range of neurologic symptoms. […] The presentation varies from an asymptomatic state, to ringing or humming in the ear (or pulsatile tinnitus) to life-threatening or fatal bleeding in the brain. […] It is important to tailor management of DAVF to each patient. […] Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient’s symptoms. […] Most dural fistulas can be managed by endovascular means but some are more appropriately approached by surgery. […] Some difficult lesions need the judicious combination of endovascular techniques and surgery.

• #27 Updates in the management of cranial dural arteriovenous fistula | Stroke and Vascular Neurology

  https://svn.bmj.com/content/5/1/50

  Endovascular approach is the first-line treatment for most dAVFs. The mainstay for endovascular treatment involves embolisation of the fistulous connection and its venous components while preventing adverse effects. […] A transarterial approach is the preferred treatment for high-grade dAVFs with direct cortical venous drainage or in cases in which transvenous approach is limited. […] Transvenous approach is preferred when a dAVF is supplied by small tortuous arteries excluding safe transarterial access to fistulous part, when dAVF is only supplied by branches directly from the ICA or vertebral artery, when dAVF is supplied by arteries with dangerous extracranial to intracranial anastomosis, or when the dAVF is supplied by nutrient arteries of cranial nerves. […] While endovascular techniques are often considered first-line therapy for treatment of dAVFs, surgery remains an alternate effective and safe option.

• #28 Updates in the management of cranial dural arteriovenous fistula | Stroke and Vascular Neurology

  https://svn.bmj.com/content/5/1/50

  Endovascular approach is the first-line treatment for most dAVFs. The mainstay for endovascular treatment involves embolisation of the fistulous connection and its venous components while preventing adverse effects. […] A transarterial approach is the preferred treatment for high-grade dAVFs with direct cortical venous drainage or in cases in which transvenous approach is limited. […] Transvenous approach is preferred when a dAVF is supplied by small tortuous arteries excluding safe transarterial access to fistulous part, when dAVF is only supplied by branches directly from the ICA or vertebral artery, when dAVF is supplied by arteries with dangerous extracranial to intracranial anastomosis, or when the dAVF is supplied by nutrient arteries of cranial nerves. […] While endovascular techniques are often considered first-line therapy for treatment of dAVFs, surgery remains an alternate effective and safe option.

• #29 Updates in the management of cranial dural arteriovenous fistula

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7213517/

  Endovascular approach is the first-line treatment for most dAVFs. The mainstay for endovascular treatment involves embolisation of the fistulous connection and its venous components while preventing adverse effects. Inappropriate embolisation of the fistulous connection and venous portions could cause sudden changes in the flow dynamics and potentially worsen cortical venous flow. Therefore, it is imperative to have an in-depth understanding of the fistula and its arterial and venous components prior to initiating treatment. […] A transarterial approach is the preferred treatment for high-grade dAVFs with direct cortical venous drainage or in cases in which transvenous approach is limited. Advantages of transarterial embolisation include decreased chance of flow redirection into an alternate venous pathway, ability to save functional venous system, avoidance of post-treatment de novo dAVF formation from venous hypertension and decreased complications specific to commonly used transvenous approaches.

• #30 Updates in the management of cranial dural arteriovenous fistula | Stroke and Vascular Neurology

  https://svn.bmj.com/content/5/1/50

  Endovascular approach is the first-line treatment for most dAVFs. The mainstay for endovascular treatment involves embolisation of the fistulous connection and its venous components while preventing adverse effects. […] A transarterial approach is the preferred treatment for high-grade dAVFs with direct cortical venous drainage or in cases in which transvenous approach is limited. […] Transvenous approach is preferred when a dAVF is supplied by small tortuous arteries excluding safe transarterial access to fistulous part, when dAVF is only supplied by branches directly from the ICA or vertebral artery, when dAVF is supplied by arteries with dangerous extracranial to intracranial anastomosis, or when the dAVF is supplied by nutrient arteries of cranial nerves. […] While endovascular techniques are often considered first-line therapy for treatment of dAVFs, surgery remains an alternate effective and safe option.

• #31 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532274/

  Dural arteriovenous fistulas, sometimes referred to as dural arteriovenous malformations, are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. […] This activity outlines how to properly evaluate dural arteriovenous fistulas, and highlights the role of the interprofessional team in caring for patients with this condition. […] The decision of whether to treat dAVFs is based on the patient’s symptoms, medical comorbidities, and risk of intracranial hypertension or hemorrhage. […] Post-treatment, the nurse is vital for monitoring the neurological exam and helping with ambulation and feeding. The nurse also plays a role in educating the patient and family about the disease and the potential adverse effects of treatment. […] An integrated approach with a team of healthcare professionals is recommended to make an early diagnosis and appropriate treatment.

• #32 Dural Arteriovenous Fistula Treatment Sydney – CURA Medical SpecialistsCURA Specialists

  https://curaspecialists.com.au/conditions/dural-arteriovenous-fistula-treatment-sydney/

  Should an endovascular embolisation not be possible, a microsurgical resection is the next treatment option. During this procedure, a DAVF is isolated from the spinal cord or the brain using a microscope. […] Patients usually recover within the first 3 months after one of the above treatment options. Rehabilitation such as occupational therapy, physiotherapy and rehabilitation nursing is recommended for post-treatment.

• #33 Intracranial dural arteriovenous fistula causing a myelopathy | Spinal Cord

  https://www.nature.com/articles/3101355

  The patient underwent a comprehensive rehabilitation program at the spinal cord unit. At discharge the patient was independent in activities of daily living. He was able to ambulate up to 300 feet using a front wheel walker and required a manual wheelchair for community mobility. The patient’s bowel program was digital stimulation every other day and his bladder was managed with a Foley catheter. […] The patient participated in a full rehabilitation program that included physical therapy, which began with pre-gait training and eventually progressed to gait activities through range of motion, stretching and strengthening exercises. He had occupational therapy to address self-care activities including feeding, bathing, dressing, toileting, transfers and wheelchair propulsion for community level mobility. Another important component was intervention and treatment by the psychosocial team to assist with coping mechanisms, as depression and decreased motivation were barriers to progress in his rehabilitation program. Although the patient did not have a definitive correction of the pathology that produced the myelopathy, close medical management to correct factors that may contribute to his condition combined with a comprehensive rehabilitation program produced an outcome of functional gains by discharge.

• #34 Intracranial dural arteriovenous fistula causing a myelopathy | Spinal Cord

  https://www.nature.com/articles/3101355

  The patient underwent a comprehensive rehabilitation program at the spinal cord unit. At discharge the patient was independent in activities of daily living. He was able to ambulate up to 300 feet using a front wheel walker and required a manual wheelchair for community mobility. The patient’s bowel program was digital stimulation every other day and his bladder was managed with a Foley catheter. […] The patient participated in a full rehabilitation program that included physical therapy, which began with pre-gait training and eventually progressed to gait activities through range of motion, stretching and strengthening exercises. He had occupational therapy to address self-care activities including feeding, bathing, dressing, toileting, transfers and wheelchair propulsion for community level mobility. Another important component was intervention and treatment by the psychosocial team to assist with coping mechanisms, as depression and decreased motivation were barriers to progress in his rehabilitation program. Although the patient did not have a definitive correction of the pathology that produced the myelopathy, close medical management to correct factors that may contribute to his condition combined with a comprehensive rehabilitation program produced an outcome of functional gains by discharge.

• #35 Intracranial dural arteriovenous fistula causing a myelopathy | Spinal Cord

  https://www.nature.com/articles/3101355

  The patient underwent a comprehensive rehabilitation program at the spinal cord unit. At discharge the patient was independent in activities of daily living. He was able to ambulate up to 300 feet using a front wheel walker and required a manual wheelchair for community mobility. The patient’s bowel program was digital stimulation every other day and his bladder was managed with a Foley catheter. […] The patient participated in a full rehabilitation program that included physical therapy, which began with pre-gait training and eventually progressed to gait activities through range of motion, stretching and strengthening exercises. He had occupational therapy to address self-care activities including feeding, bathing, dressing, toileting, transfers and wheelchair propulsion for community level mobility. Another important component was intervention and treatment by the psychosocial team to assist with coping mechanisms, as depression and decreased motivation were barriers to progress in his rehabilitation program. Although the patient did not have a definitive correction of the pathology that produced the myelopathy, close medical management to correct factors that may contribute to his condition combined with a comprehensive rehabilitation program produced an outcome of functional gains by discharge.

• #36 Arteriovenous Fistula Survival | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/survival/overview

  Recovery time after dAVF treatment varies based on the chosen treatment, the fistulas location and complexity, and the individual patients health. […] Each patients recovery journey is unique, and its essential to follow post-treatment care instructions to ensure the best possible outcome. Patients are encouraged to discuss their specific recovery expectations with their doctor, who can provide guidance based on individual factors. […] Regular follow-up appointments, often including imaging, help ensure that any recurrence is detected and managed early. This proactive approach allows for timely intervention if new or returning symptoms arise, which can minimize the impact on a patients health. […] Even after successful treatment, ongoing monitoring of a dAVF is crucial. Regular follow-up appointments help healthcare providers assess the stability of the treated dAVF and monitor for any signs of recurrence.

• #37

  https://scholars.duke.edu/individual/pub1519728

  OBJECTIVE: Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. […] Many patients (85%, 911/1077) underwent treatment via endovascular embolization (55%, 587/1077), surgery (10%, 103/1077), radiosurgery (3%, 36/1077), or multimodal therapy (17%, 184/1077). […] The overall angiographic cure rate was 83% (758/911 treated), and treatment-related permanent neurological morbidity was 2% (27/1467 total procedures). […] These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.

• #38 Spinal dural arteriovenous fistula: a comprehensive review of the history, classification systems, management, and prognosis | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-023-00355-y

  Spinal dural arteriovenous fistulas account for the majority of spinal vascular malformations. They are typically located in the thoracolumbar region and are diagnosed in the middle-aged and elderly populations. The management includes surgery, endovascular therapy, and in selected cases, radiotherapy. The treatment goal of spinal dural arteriovenous fistula is to halt the progression of the disease. Surgical occlusion is considered the mainstay, most definitive, and curative treatment modality for spinal dural arteriovenous fistula, due to its safety, effectiveness, and improvement of neurologic symptoms in most patients. If embolization fails or is not possible due to anatomy-related issues, surgical therapy can be considered as a standby and is often successful in curing patients with low morbidity. Steinmetz and collaborators recommended surgical treatment as the first-line therapy in dealing with spinal dural arteriovenous fistula, because it has a successful occlusion rate of 98%, with 2% morbidity and no mortality. A multidisciplinary approach based on close collaboration between endovascular specialists and neurosurgeons is required to determine the best initial treatment method for each patient with this type of lesion in order to provide optimal care, which will in turn ensure better clinical outcomes. The prognosis depends on both the duration of symptoms as well as the clinical condition prior to therapy. After complete occlusion of the fistula, approximately two thirds of the patients would have regression of their motor symptoms and only one third would show improvement in their sensory disturbances.

• #39 Spinal dural arteriovenous fistula: a comprehensive review of the history, classification systems, management, and prognosis | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-023-00355-y

  Spinal dural arteriovenous fistulas account for the majority of spinal vascular malformations. They are typically located in the thoracolumbar region and are diagnosed in the middle-aged and elderly populations. The management includes surgery, endovascular therapy, and in selected cases, radiotherapy. The treatment goal of spinal dural arteriovenous fistula is to halt the progression of the disease. Surgical occlusion is considered the mainstay, most definitive, and curative treatment modality for spinal dural arteriovenous fistula, due to its safety, effectiveness, and improvement of neurologic symptoms in most patients. If embolization fails or is not possible due to anatomy-related issues, surgical therapy can be considered as a standby and is often successful in curing patients with low morbidity. Steinmetz and collaborators recommended surgical treatment as the first-line therapy in dealing with spinal dural arteriovenous fistula, because it has a successful occlusion rate of 98%, with 2% morbidity and no mortality. A multidisciplinary approach based on close collaboration between endovascular specialists and neurosurgeons is required to determine the best initial treatment method for each patient with this type of lesion in order to provide optimal care, which will in turn ensure better clinical outcomes. The prognosis depends on both the duration of symptoms as well as the clinical condition prior to therapy. After complete occlusion of the fistula, approximately two thirds of the patients would have regression of their motor symptoms and only one third would show improvement in their sensory disturbances.

• #40 Spinal dural arteriovenous fistula: a comprehensive review of the history, classification systems, management, and prognosis | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-023-00355-y

  Spinal dural arteriovenous fistulas account for the majority of spinal vascular malformations. They are typically located in the thoracolumbar region and are diagnosed in the middle-aged and elderly populations. The management includes surgery, endovascular therapy, and in selected cases, radiotherapy. The treatment goal of spinal dural arteriovenous fistula is to halt the progression of the disease. Surgical occlusion is considered the mainstay, most definitive, and curative treatment modality for spinal dural arteriovenous fistula, due to its safety, effectiveness, and improvement of neurologic symptoms in most patients. If embolization fails or is not possible due to anatomy-related issues, surgical therapy can be considered as a standby and is often successful in curing patients with low morbidity. Steinmetz and collaborators recommended surgical treatment as the first-line therapy in dealing with spinal dural arteriovenous fistula, because it has a successful occlusion rate of 98%, with 2% morbidity and no mortality. A multidisciplinary approach based on close collaboration between endovascular specialists and neurosurgeons is required to determine the best initial treatment method for each patient with this type of lesion in order to provide optimal care, which will in turn ensure better clinical outcomes. The prognosis depends on both the duration of symptoms as well as the clinical condition prior to therapy. After complete occlusion of the fistula, approximately two thirds of the patients would have regression of their motor symptoms and only one third would show improvement in their sensory disturbances.

• #41 Spinal dural arteriovenous fistula: a comprehensive review of the history, classification systems, management, and prognosis | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-023-00355-y

  Spinal dural arteriovenous fistulas account for the majority of spinal vascular malformations. They are typically located in the thoracolumbar region and are diagnosed in the middle-aged and elderly populations. The management includes surgery, endovascular therapy, and in selected cases, radiotherapy. The treatment goal of spinal dural arteriovenous fistula is to halt the progression of the disease. Surgical occlusion is considered the mainstay, most definitive, and curative treatment modality for spinal dural arteriovenous fistula, due to its safety, effectiveness, and improvement of neurologic symptoms in most patients. If embolization fails or is not possible due to anatomy-related issues, surgical therapy can be considered as a standby and is often successful in curing patients with low morbidity. Steinmetz and collaborators recommended surgical treatment as the first-line therapy in dealing with spinal dural arteriovenous fistula, because it has a successful occlusion rate of 98%, with 2% morbidity and no mortality. A multidisciplinary approach based on close collaboration between endovascular specialists and neurosurgeons is required to determine the best initial treatment method for each patient with this type of lesion in order to provide optimal care, which will in turn ensure better clinical outcomes. The prognosis depends on both the duration of symptoms as well as the clinical condition prior to therapy. After complete occlusion of the fistula, approximately two thirds of the patients would have regression of their motor symptoms and only one third would show improvement in their sensory disturbances.

• #42 A Rare and Treatable Cause of Medullar Claudication: Spinal Dural Arteriovenous Fistula | Ochsner Journal

  https://www.ochsnerjournal.org/content/19/4/397

  Spinal dural arteriovenous fistula is a rare and underdiagnosed disorder. […] Physicians should be aware of the specific abnormalities shown on spinal cord MRI that indicate dural arteriovenous fistula, as well as the criteria for performing medullar angiography, so that the condition can be diagnosed and treated in a timely manner. Early therapeutic treatment is the principal prognosis factor. […] Imaging is crucial to confirm the diagnosis of spinal dural arteriovenous fistula. […] Medullar angiography is the gold standard for diagnosis and must be performed according to specific criteria. […] Once the fistula is visualized, a therapeutic discussion is necessary. Endovascular treatment can be performed by using a liquid agent (glue) to embolize the fistula point. […] After treatment, symptoms generally improve, particularly motor symptoms. Prognosis depends on the level of severity of neurologic disturbance, early diagnosis, and early therapeutic treatment.

• #43 A Rare and Treatable Cause of Medullar Claudication: Spinal Dural Arteriovenous Fistula | Ochsner Journal

  https://www.ochsnerjournal.org/content/19/4/397

  Although dural arteriovenous fistula is the most common spinal vascular malformation, it is still underdiagnosed because of its nonspecific clinical presentation and many physicians lack of knowledge about its specific abnormalities shown on spinal cord MRI. Medullar angiography is the gold standard for diagnosis but must be performed according to strict criteria to identify the abnormality. Early therapeutic treatment is the principal factor affecting prognosis.

• #44 Treatment Within Five Days for Dural Arteriovenous Fistula Hemorrhage

  https://www.brighamhealthonamission.org/2022/10/14/treatment-within-five-days-generally-appropriate-for-dural-arteriovenous-fistula-related-hemorrhage/

  Treatment Within Five Days Generally Appropriate for Dural Arteriovenous Fistularelated Hemorrhage […] In Stroke, the team says treatment within five days was associated with a low rate of an early rebleed and appears to be an appropriate timeframe. […] These data suggest treatment within five days is acceptable. In general, though, earlier is better, up to the point where the quality of the procedure may be compromised.

• #45 Spinal dural arteriovenous fistula: a comprehensive review of the history, classification systems, management, and prognosis | Chinese Neurosurgical Journal | Full Text

  https://cnjournal.biomedcentral.com/articles/10.1186/s41016-023-00355-y

  Spinal dural arteriovenous fistulas account for the majority of spinal vascular malformations. They are typically located in the thoracolumbar region and are diagnosed in the middle-aged and elderly populations. The management includes surgery, endovascular therapy, and in selected cases, radiotherapy. The treatment goal of spinal dural arteriovenous fistula is to halt the progression of the disease. Surgical occlusion is considered the mainstay, most definitive, and curative treatment modality for spinal dural arteriovenous fistula, due to its safety, effectiveness, and improvement of neurologic symptoms in most patients. If embolization fails or is not possible due to anatomy-related issues, surgical therapy can be considered as a standby and is often successful in curing patients with low morbidity. Steinmetz and collaborators recommended surgical treatment as the first-line therapy in dealing with spinal dural arteriovenous fistula, because it has a successful occlusion rate of 98%, with 2% morbidity and no mortality. A multidisciplinary approach based on close collaboration between endovascular specialists and neurosurgeons is required to determine the best initial treatment method for each patient with this type of lesion in order to provide optimal care, which will in turn ensure better clinical outcomes. The prognosis depends on both the duration of symptoms as well as the clinical condition prior to therapy. After complete occlusion of the fistula, approximately two thirds of the patients would have regression of their motor symptoms and only one third would show improvement in their sensory disturbances.

• #46 Endovascular Surgery Restores Function for Patient with Dural AV Fistula

  https://www.barrowneuro.org/about/news-and-articles/patient-stories/endovascular-surgery-restores-function-for-patient-with-dural-av-fistula/

  Mark był w Neuro-Intensywnej Opiece w Barrow Neurological Institute w Phoenix. […] Po operacji endowaskularnej Mark obudził się i spotkał się ponownie z Dr. Albuquerque, który powiedział mu, że procedura była udana i że Mark może oczekiwać pełnego powrotu do zdrowia. […] Dr. Albuquerque powiedział: „Pan Barrett zgłosił się do nas z postępującą słabością nóg, brakiem równowagi i problemami z funkcją pęcherza. Te poważne objawy są klasycznymi objawami u pacjentów z rdzeniowymi przetokami tętniczo-żylno-żylnymi.” […] „W przypadku pana Barrett’a udało nam się zlokalizować krótki obwód i zablokować go, wstrzykując płynny, przypominający klej substancję bezpośrednio w miejsce przetoki.” […] „Pacjenci tacy jak pan Barrett często stają się coraz gorsi i mogą pogorszyć się do punktu całkowitego paraliżu i nietrzymania moczu.” […] „Czuję się bardzo wdzięczny, że żyjemy w miejscu, gdzie mamy dostęp do naprawdę doskonałej opieki zdrowotnej i takiej placówki jak Barrow.”

• #47 Dural Arteriovenous Fistula Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/dural-arteriovenous-fistula

  A dural arteriovenous fistula (DAVF), also called a dural arteriovenous malformation (dural AVM), is an atypical connection between blood vessels in the dura. When necessary, surgical treatment for DAVF most commonly takes the form of endovascular embolization, microsurgical resection, or stereotactic radiosurgery. […] Dural arteriovenous fistulas are complex lesions and should be managed at major centers with specialists highly trained in their treatment. At Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, our neurosurgeons are experienced in evaluating DAVFs and in treating them surgically when necessary. […] The current treatment of choice for other DAVFs is endovascular embolization. To perform this procedure, a specialist inserts a catheter through an artery in the groin and then guides the catheter through the circulatory system to the site of the DAVF. Once in position, the catheter delivers a kind of glue. The glue embolizes the abnormal passageway, blocking the abnormal connection often permanently curing the fistula.

• #48 Dural arteriovenous fistulas – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dural-arteriovenous-fistulas/diagnosis-treatment/drc-20364281

  Our caring team of Mayo Clinic experts can help you with your dural arteriovenous fistulas-related health concerns […] Treatment for a dural arteriovenous fistula (dAVF) involves a procedure to block or disconnect the fistula. […] Procedures that can treat dAVF include: […] In an endovascular procedure, a long, thin tube called a catheter is inserted into a blood vessel in your leg or groin. It is threaded through blood vessels to the dural arteriovenous fistula using X-ray imaging. Coils or a glue-like substance is released to block the connection in the blood vessels. […] In stereotactic radiosurgery, precisely focused radiation blocks the irregular connection in the blood vessels. This causes blood vessels in the fistula to close off, destroying the dAVF. […] If an endovascular procedure or stereotactic radiosurgery aren’t options for you, you may need dAVF surgery. Surgery may be performed to disconnect the dAVF or cut off the blood supply and remove the fistula. […] Dural arteriovenous fistulas care at Mayo Clinic.

• #49 Dural Arteriovenous Fistula (DAVF) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/dural-arteriovenous-fistula-davf

  Dural arteriovenous fistulas (DAVF) are abnormal connections between arteries and veins near the brain. […] These are acquired lesions that occur most commonly without an obvious cause, but can be associated with trauma, surgery, tumors, or previous infections near the area of the lesion. […] While dural arteriovenous fistulas are lesions outside the brain, they may present with a wide range of neurologic symptoms. […] The presentation varies from an asymptomatic state, to ringing or humming in the ear (or pulsatile tinnitus) to life-threatening or fatal bleeding in the brain. […] It is important to tailor management of DAVF to each patient. […] Specific goals should be put forward taking into account the natural history of the lesion (which mainly depends on its venous drainage pattern), its specific anatomical features and the patient’s symptoms. […] Most dural fistulas can be managed by endovascular means but some are more appropriately approached by surgery. […] Some difficult lesions need the judicious combination of endovascular techniques and surgery.

• #50 Intracranial dural arteriovenous fistula causing a myelopathy | Spinal Cord

  https://www.nature.com/articles/3101355

  The patient underwent a comprehensive rehabilitation program at the spinal cord unit. At discharge the patient was independent in activities of daily living. He was able to ambulate up to 300 feet using a front wheel walker and required a manual wheelchair for community mobility. The patient’s bowel program was digital stimulation every other day and his bladder was managed with a Foley catheter. […] The patient participated in a full rehabilitation program that included physical therapy, which began with pre-gait training and eventually progressed to gait activities through range of motion, stretching and strengthening exercises. He had occupational therapy to address self-care activities including feeding, bathing, dressing, toileting, transfers and wheelchair propulsion for community level mobility. Another important component was intervention and treatment by the psychosocial team to assist with coping mechanisms, as depression and decreased motivation were barriers to progress in his rehabilitation program. Although the patient did not have a definitive correction of the pathology that produced the myelopathy, close medical management to correct factors that may contribute to his condition combined with a comprehensive rehabilitation program produced an outcome of functional gains by discharge.

• #51 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532274/

  Dural arteriovenous fistulas, sometimes referred to as dural arteriovenous malformations, are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. […] This activity outlines how to properly evaluate dural arteriovenous fistulas, and highlights the role of the interprofessional team in caring for patients with this condition. […] The decision of whether to treat dAVFs is based on the patient’s symptoms, medical comorbidities, and risk of intracranial hypertension or hemorrhage. […] Post-treatment, the nurse is vital for monitoring the neurological exam and helping with ambulation and feeding. The nurse also plays a role in educating the patient and family about the disease and the potential adverse effects of treatment. […] An integrated approach with a team of healthcare professionals is recommended to make an early diagnosis and appropriate treatment.

• #52 Arteriovenous Fistula Survival | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/survival/overview

  A dural arteriovenous fistula (dAVF) is a rare vascular disorder that occurs when there is an abnormal connection between the arteries and veins in the dura mater, the tough outer membrane that covers the brain and spinal cord. This abnormal connection causes blood to flow directly from an artery to a vein, bypassing the normal capillary system. […] Once diagnosed, the treatment goal for a dAVF is to stop the abnormal blood flow, which can be achieved through various surgical or endovascular techniques. The specific approach depends on the fistula’s characteristics and the patient’s overall health. […] Maintaining regular follow-up with your care team is essential for those with dAVFs to ensure stability and address any emerging symptoms. […] Each of these treatments aims to restore normal blood flow, and many patients achieve a cure in that the fistula no longer affects their health or quality of life. However, close monitoring post-treatment is essential to detect any changes or complications early.

• #53 Dural Arteriovenous Fistula – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532274/

  Dural arteriovenous fistulas, sometimes referred to as dural arteriovenous malformations, are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. […] This activity outlines how to properly evaluate dural arteriovenous fistulas, and highlights the role of the interprofessional team in caring for patients with this condition. […] The decision of whether to treat dAVFs is based on the patient’s symptoms, medical comorbidities, and risk of intracranial hypertension or hemorrhage. […] Post-treatment, the nurse is vital for monitoring the neurological exam and helping with ambulation and feeding. The nurse also plays a role in educating the patient and family about the disease and the potential adverse effects of treatment. […] An integrated approach with a team of healthcare professionals is recommended to make an early diagnosis and appropriate treatment.

• #54 Arteriovenous Fistula Survival | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/survival/overview

  A dural arteriovenous fistula (dAVF) is a rare vascular disorder that occurs when there is an abnormal connection between the arteries and veins in the dura mater, the tough outer membrane that covers the brain and spinal cord. This abnormal connection causes blood to flow directly from an artery to a vein, bypassing the normal capillary system. […] Once diagnosed, the treatment goal for a dAVF is to stop the abnormal blood flow, which can be achieved through various surgical or endovascular techniques. The specific approach depends on the fistula’s characteristics and the patient’s overall health. […] Maintaining regular follow-up with your care team is essential for those with dAVFs to ensure stability and address any emerging symptoms. […] Each of these treatments aims to restore normal blood flow, and many patients achieve a cure in that the fistula no longer affects their health or quality of life. However, close monitoring post-treatment is essential to detect any changes or complications early.

• #55 Arteriovenous Fistula Survival | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/arteriovenous-fistula/survival/overview

  Recovery time after dAVF treatment varies based on the chosen treatment, the fistulas location and complexity, and the individual patients health. […] Each patients recovery journey is unique, and its essential to follow post-treatment care instructions to ensure the best possible outcome. Patients are encouraged to discuss their specific recovery expectations with their doctor, who can provide guidance based on individual factors. […] Regular follow-up appointments, often including imaging, help ensure that any recurrence is detected and managed early. This proactive approach allows for timely intervention if new or returning symptoms arise, which can minimize the impact on a patients health. […] Even after successful treatment, ongoing monitoring of a dAVF is crucial. Regular follow-up appointments help healthcare providers assess the stability of the treated dAVF and monitor for any signs of recurrence.

• #56 A Rare and Treatable Cause of Medullar Claudication: Spinal Dural Arteriovenous Fistula | Ochsner Journal

  https://www.ochsnerjournal.org/content/19/4/397

  Although dural arteriovenous fistula is the most common spinal vascular malformation, it is still underdiagnosed because of its nonspecific clinical presentation and many physicians lack of knowledge about its specific abnormalities shown on spinal cord MRI. Medullar angiography is the gold standard for diagnosis but must be performed according to strict criteria to identify the abnormality. Early therapeutic treatment is the principal factor affecting prognosis.

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