Surgical treatment of anterior cranial fossa dural arterio-venous fistulas (DAVFs): a two-centre experience

Abstract

Surgical exclusion of the anterior cranial fossa DAVFs still represents the gold standard for such lesions, due to low post-operative morbidity and to complete protection against future rebleedings; endovascular techniques may help the surgeon in complex cases.

Current status of endovascular treatment for dural arteriovenous fistulae in the anterior cranial fossa: A systematic literature review

“…These vascular events are notorious for their proclivity to drain directly into cortical veins, indicating a malignant natural history and a high bleeding risk in 91% of cases. Hence, ACF DAVFs are usually treated regardless of whether they are symptomatic 4, 8.…”

“…Currently, treatments for ACF DAVFs include surgical resection, endovascular treatment (EVT) and stereotactic radiosurgery 9. Surgical resection is very effective because it has low postoperative morbidity and can achieve a complete cure 8, 10. However, surgical resection is also associated with risks inherent to frontal craniotomy, including fontal sinus opening, cerebrospinal fluid leakage, intradural infection, and retraction damage to the frontal lobe and olfactory nerves 11.…”

“…Recently, trends in the management of ACF DAVF have been significantly affected by technological advances in EVT related to the widespread use of new microcatheters, and morbidity and modality have apparently been reduced 8. Since its introduction in 2000, the Onyx Liquid Embolic System (Irvine, CA, USA) has been widely used for embolization in DAVFs and is easier to control than previously available liquid agents 12, 13.…”

Ethmoidal dural Arteriovenous Fistula- A case report

“…3,4,5 Due to its location and the risk of occluding the ophthalmic artery, an open surgical approach has been adopted by most of the surgeons. 6,7 Case summary A 52-year-old right-handed gentleman was brought into the emergency department with the complaint of headache for nine days, which was gradually progressive, and got severe for the last few hours. lesions which needs to be tackled surgically.…”

“…lesions which needs to be tackled surgically. 6,7 However, recently there literature suggesting usefulness of endovascular management, which involves either obliteration of the lesion through venous route, or embolization through transarterial route. 4,5 Though relatively uncommon, there is a greater risk of obliterating the ophthalmic artery when dealing with the lesion through the transarterial route and thus risk in the vision of the patient.…”