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Dural Arteriovenous Fistulas

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  • Dural arteriovenous fistulas

    Dural arteriovenous fistulas re a heterogeneous collection of conditions that share arteriovenous shunts from dural vessels. They make up 10-15% of all cerebral vascular malformations. It is also known as Arteriovenous fistula. The disease describes an abnormal communication between an artery and a vein. These communications are congenital; can occur at any point in the vascular system; and vary in size, length, location, and number. The first recorded case of an arteriovenous malformation (AVM) was in the late 16th century. In 1757, Hunter described an AVF as an abnormal communication between an artery and a vein. Krause in 1862 used injection studies of an amputated specimen to characterize the abnormal vasculature. In 1875, Nicoladoni described the reflex slowing of the pulse following occlusion of an artery proximal to an AVM.

  • Dural arteriovenous fistulas

    The symptoms mainly includes:

    • Tinnitus

    • Cranial Nerve Palsies

    • Orbital Symptoms

    • Symptoms of Venous hypertension

  • Dural arteriovenous fistulas

    Intracranial dural arteriovenous malformations are unique and rare pathological entities. Dural arteriovenous fistulas are abnormal arteriovenous connections within the dura and are usually located within the walls of a dural sinus or an adjacent cortical vein. Most arteriovenous malformations (AVMs) can be medically managed and controlled; only a few demonstrate progressive growth and warrant surgical intervention. An elastic support stocking that provides 30-40 mm Hg of compression is usually sufficient to relieve leg symptoms. Alcohol sclerotherapy may shrink the size of the AVM, but this treatment also places the patient at risk for peripheral nerve injury. he treatment of large AVMs with alcohol must be performed by an experienced interventional radiologist, and these risks must be explained to patients when they consent to undergo therapy. Various newer treatments like photodynamic therapy, antiangiogenic therapy etc are used.

    All AVMs are present at birth, but they are not always clinically evident. Stimuli during puberty or pregnancy or following minor trauma can precipitate clinical features of the malformation. AVMs occur with equal frequency among males and females.

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