To simplify the above systems of DAVF classification, the two main factors that should be considered to determine aggressiveness of these lesions are: 

DAVF that have bleed (as opposed to those that have not before)
DAVF resulting in cortical venous refluxTreatment decisions are more complicated and require consultation with a neurosurgeon and team familiar with these lesions. Treatment
Indications
Hemorrhage
Neurologic dysfunction or refractory symptoms

Interventions
Embolization
One approach used for treatment is embolization. A six-vessel angiogram is employed to determine the vascular supply to the fistula. Detachable coils, liquid embolic agents like NBCA, and onyx, or combinations of both are injected into the blood vessel to occlude the DAVF. Preoperative embolization can also be used to supplement surgery. Surgery
DAVFs are also managed surgically. The operative approach varies depending on the location of the lesion. Stereotactic radiosurgery
Stereotactic radiosurgery is used for obliterating DAVFs sometimes in conjunction with embolization or surgery, and is considered an important adjunct and sometimes a primary treatment method for non-aggressive DAVFs. Use of this method, however, is limited as obliteration occurs over the course of up to 2–3 years after the delivery of radiation. Epidemiology
10–15% of intracranial AV malformations are DAVFs. There is a higher preponderance in females (61–66%), and typically patients are in their fourth or fifth generation of life. DAVFs are rarer in children. Research
External Manual Carotid Compression is Effective in Patients with Cavernous Sinus Dural Arteriovenous Fistulaetreatment.
The patients were instructed to compress the carotid artery and jugular vein with the contralateral hand for ten seconds several times each hour (about 6 to 15 times per day). [1]

See also
Arteriovenous fistula

References


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