The Surgical Treatment of Cranial Dural Arteriovenous Fistulas

Abstract

The surgical treatment of dural arteriovenous fistulas at the beginning of the 21st century remains a cornerstone of treatment of these difficult lesions. The rapid advancement of endovascular treatments has allowed combined strategies with endovascular and surgical treatments to successfully treat previously untreatable lesions with minimal morbidity and mortality. There are also dural arteriovenous fistula types which remain preferentially treatable with surgery, and surgical expertise in this area remains an essential component of any treatment team. Advances in the surgical treatment of these lesions are based also on a better understanding of the natural history of these lesions, which dictates the importance of definitive treatment if at all possible. Modern imaging has also significantly advanced our understanding of these complex lesions.