Dural Arteriovenous Fistulas in Children Homepage

 

Authors

Ramon Navarro, MD

Gary K. Steinberg, MD, PhD

Section Editors

Edward Smith, MD

Gianpiero Tamburrini, MD

Alfred Pokmeng See, M.D.

Editor in Chief

Rick Abbott, MD

Introduction

Dural arteriovenous fistulas —also known as dural arteriovenous malformations —in children are exceedingly rare, thus their diagnosis and management can be difficult. Symptoms vary mostly according to age at presentation. Current therapeutic management is mainly performed by endovascular means.

Key Points

• Nidus Malformation within dura: Cranial DAVFs are abnormal arteriovenous connections between the arterial vessels and the venous sinus or leptomeningeal vein with the nidus located within the dura. They are very rare in children.
• High-risk lesions: Cranial DAVFs with cortical venous drainage are considered high-risk lesions and should be treated promptly, particularly if symptomatic.
• Neurointerventional radiologic treatment with surgery support: Most of these lesions are treated by neuro-interventional means. However, surgery can also play an important role in the management of these patients, particularly for those patients where interventional radiology could not achieve complete obliteration of the malformation, or special locations where it is technically difficult or risky to navigate endovascular devices.
• Goal to disconnect venous from arterial circulation: The goal of treatment is to disconnect the venous draining system from the fistulous point.
• High recurrence rate: There is a high recurrence rate and long-term follow-up is warranted.