Dural arteriovenous fistulas (DAVFs) are abnormal connections that are located within the dura mater, usually within the walls of a dural sinus or involving an adjacent cortical vein. DAVFs are usually classified according to either the name of the dural sinus where the fistula exists or by the anatomic location where these shunts exist. In this review the experience of the past 8 years at the University of California at San Francisco Medical Center involving 268 patients with DAVFs is presented. Although the exact etiology of DAVFs remains unknown, they are believed to be acquired lesions in most cases. Clinical presentations may be highly variable and can frequently include intracranial hemorrhage. A thorough radiological evaluation is mandatory in all instances, not only to confirm the diagnosis but also to evaluate potential high-risk features and to plan treatment. Treatment options include noninvasive measures in selected cases, but the majority of patients will require obliteration of their fistula. This may be carried out by an endovascular route, by direct surgical attack, or through a combination of these two methods. Close cooperation between interventional neuroradiologists and neurosurgeons results in the safe and effective treatment of this condition in the vast majority of patients.
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