Multidisciplinary Treatment of a Large Cerebral Dural Arteriovenous Fistula Using Embolization, Surgery, and Radiosurgery

Abstract

Dural arteriovenous fistulae are rare lesions composed of abnormal connections between meningeal arteries and the dural sinuses or leptomeningeal veins. Treatment is challenging because of the small size and wide distribution of the myriad sites of fistulous connection. We present a case of a dural arteriovenous fistula presenting with visual deterioration, pulsatile tinnitus, and intracranial hypertension that was successfully treated with a multidisciplinary approach combining angiographic, surgical, and radiosurgical intervention. This is one of the largest of these formidable lesions treated in this fashion that has been reported.