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Introduction: C-arm Cone Beam CT (CBCT) is a technology that is being integrated into many of the newer angiography systems in the interventional suite. Due to its ability to provide cross sectional imaging, it has opened a myriad of opportunities for creating new clinical applications. We review the technical aspects, current reported clinical applications and potential benefits of this technology. Materials and Methods: Searches were made via PubMed using the string “CBCT”, “Cone Beam CT”, “Cone Beam Computed Tomography” and “C-arm Cone Beam Computed Tomography”. All relevant articles in the results were reviewed. Results: CBCT clinical applications have been reported in both vascular and non-vascular interventions. They encompass many aspects of a procedure including preprocedural planning, intraprocedural guidance and postprocedural assessment. As a result, they have allowed the interventionalist to be safer and more accurate in performing image guided procedures. There are however several technical limitations. The quality of images produced is not comparable to conventional computed tomography (CT). Radiation doses are also difficult to quantify when compared to CT and fluoroscopy. Conclusion: CBCT technology in the interventional suite has contributed significant benefits to the patient despite its current limitations. It is a tool that will evolve and potentially become an integral part of imaging guidance for intervention. Key words: Angiogram, Biopsy, Embolisation, Intervention, Stenting, Vascular

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Dural arteriovenous fistulae (DAVF) constitute 10-15% of all intracranial vascular malformations. As a subtype of DAVF, tentorial DAVF are even rarer, but their aggressive nature warrants early intervention. With regards to symptoms, 70-88% of the cases present with bruits or tinnitus, 60-74% with intracranial haemorrhages, 23-42% with central nerve deficits, 14-17% with cranial nerve deficits, and finally 8-25 % with headaches. Here we report three cases of tentorial DAVF with a primary manifestation of headaches: the first patient is a 44-year-old woman who presented with a severe, persistent sharp occipital headache for 1 day. She deteriorated quickly after admission and required emergency posterior fossa decompression for evacuation of an acute right cerebellar haematoma. Intra-operative and pathological findings suggested a cerebellar arteriovenous malformation. She subsequently underwent transarterial embolisation and surgical excision of the lesion. A review of the histopathological features will be presented. The second case is a 61-year-old male with a 3-4-day history of headache and vomiting prior to presenting to the emergency department with acute delirium secondary to subarachnoid haemorrhage in the posterior fossa. The third case is a 55-year-old woman with moderate, recurrent generalised headaches for 4-5 years. She was managed expediently with transarterial embolisation and had a good outcome. In view of the poor prognosis associated with DAVF rupture, early diagnosis and treatment is warranted to achieve favourable outcomes.