Dural Arteriovenous Fistula (dAVF)

A dural arteriovenous fistula is an abnormal connection between arteries and veins within the dura, the protective covering of the brain. This allows blood to bypass the normal small vessels and flow directly from arteries into veins.

No. A dAVF develops within the dura, while a brain arteriovenous malformation (AVM) involves abnormal blood vessels within brain tissue. They are different vascular conditions and may require different treatment approaches.

Abnormal blood flow through a dAVF can create a rhythmic pulsing or whooshing sound called pulsatile tinnitus. The sound often matches the heartbeat and may be heard in one ear.

Some dAVFs are lower risk, while others can cause bleeding or neurological injury. Risk depends heavily on how the fistula drains, particularly whether abnormal blood flow is directed into cortical veins.

MRI or CT may identify signs of abnormal blood flow, venous congestion, or bleeding. Cerebral angiography provides the most detailed view of the feeding arteries, fistulous connection, and draining veins and is important for determining risk and planning treatment.

Not necessarily. Some lower-risk fistulas may be monitored, depending on their venous drainage pattern and symptoms. Higher-risk fistulas, particularly those with cortical venous drainage, are more likely to require treatment.

Endovascular embolization is often used to close the abnormal connection from inside the blood vessels. Depending on the anatomy of the fistula, microsurgical disconnection or stereotactic radiosurgery may also be considered.

A successfully treated dAVF may require follow-up imaging to confirm that the abnormal connection remains closed. The type and timing of follow-up depend on the fistula and treatment performed.