Intra-cranial dural arteriovenous fistula: Classification and treatment

Kenji Sugiu, Masafumi Hiramatsu, Koji Tokunaga, Tomohito Hishikawa, Yu Ohkuma, Jun Haruma, Tomohisa Shimizu, Isao Date

Research output: Contribution to journalArticlepeer-review


Intracranial dural arteriovenous fistulas (dAVFs) are pathologic dural-based shunts and distinguished from parenchymal AVM by the presence of a dural arterial supply and the absence of a parenchymal nidus. Their symptoms and prognosis are strongly related to the pattern of their venous drainage system. The presence of cortical venous reflux (CVR) is an aggressive feature indicating that there is a high risk of cerebral bleeding or progressive neurological deficits. Endovascular treatment has become the mainstream dAVF therapy. In general, trans-venous coil embolization is adapted to sinusal type dAVFs (i.e. cavernous sinus or transverse-sigmoid dAVFs) and trans-arterial glue embolization is applied to non-sinusal type dAVFs (i.e. anterior skull base or tentorial dAVFs). Direct surgery and stereotactic radiosurgery are indicated in cases in which endovascular approaches have failed or are not feasible.

Original languageEnglish
Pages (from-to)37-43
Number of pages7
JournalJapanese Journal of Neurosurgery
Issue number1
Publication statusPublished - 2013


  • Coil
  • Cortical venous reflux
  • Embolization

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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