We review the classifications,
radiological findings and management of non-cavernous cranial dural arteriovenous fistulae (DAVF),
focusing on the ones with cortical vein drainage.
We want to set some imaging clues that could help us in the diagnosis of intracranial DAVF.
DAVF are a rare intracranial vascular malformation (10% to 15% of intracranial shunts) within the dural leaflets,
characterized by abnormal connections between meningeal arteries and dural venous sinuses,
or cortical veins.
Fistulaes are distinguished from arteriovenous malformations by the lack of a parenchymal nidus and the existence of dural arterial supply.
Most reported intracranial DAVF involve the transverse-sigmoid sinuses (38%),
and the cavernous sinus (35%),
followed by the tentorium,
superior sagittal sinus and dura of the anterior cranial fossa.
They are typically...
Findings and procedure details
MATERIAL AND METHODS
Imaging exams of 17 patients with "aggressive" DAVF confirmed by DSA (cavernous cranial DAVF were excluded),
which occurred in the last 4 years in our hospital were reviewed,
to find out imaging clues that could suggest the diagnosis in the conventional CT and MR.
One of our patients had two fistulas at the same time Fig. 11 so 18 cases of DAVF were available to study.
There was not significant differences between men and women (9 males and 8 females).
Venous congestion as a result of the presence of CVD in DAVF is manifested in CT and MR,
as focal venous ectasia,
dilated ECA branches,
cluster of vessels surrounding dural venous sinus,
thrombosis of the dural venous sinuses,
mainly as dilated leptomeningeal vessels and medullary vessels.
Venous congestion has been identified as a risk factor for DAVF rupture and may produce local mass effect.
Although angiography remains the gold standard in the diagnosis and classification of DAVF,
Angioarchitecture of Transverse-Sigmoid Sinus Dural Arteriovenous Fistulas: Evaluation of Shunted Pouches by Multiplanar Reformatted Images of Rotational Angiography.
AJNR Am J Neuroradiol.
 Laurent Letourneau-Guillon (MD),
Juan Pablo Cruz (MD),
Timo Krings (MD PhD).
CT and MR imaging of non-cavernous cranial dural arteriovenous fistulas: Findings associated with cortical venous reflux.
European Journal of Radiology 84 (2015) 1555–1563
 Sivasankar R,