A dural arteriovenous fistula (DAVF) is a rare abnormal connection between arteries and veins in the brain or spinal cord. Symptoms include ringing in the ears, headache, weakness, and paralysis. Timely diagnosis and treatment are crucial to prevent serious complications, such as cerebral hemorrhage and seizures. Diagnosis is made through tests such as MRI or angiography, and treatment involves specialized neurosurgery.
A dural arteriovenous fistula (DAVF) is an abnormal connection of arteries and veins in the dura, the covering of the brain or spinal cord. A FAD may also be referred to as a dural arteriovenous malformation (AMD). FADs are rare and typically develop in middle-aged or older people, but they can occur at any age or be present from birth. People who have diabetes, cancer, AIDS, Crohn’s disease, inflammatory bowel disease, or other diseases that affect the immune system or gastrointestinal organs have a higher risk of developing fistulas.
People who develop a dural arteriovenous fistula in their head may hear a ringing or ringing in their ears. Other symptoms include eye swelling, headache, and weakness. Some symptoms of DAVF in the lining of the brain are very similar to stroke symptoms, including numbness, paralysis on one side of the body, and problems with balance, memory, and vision. DAVFs in the spine can cause decreased leg, bowel, or bladder function. The symptoms of spinal FAD are usually progressive, meaning they are mild at first and get worse over time.
A DAVF can cause serious medical problems and can be fatal in some cases. Cerebral hemorrhage and seizures are the most serious complications of a dural arteriovenous fistula in the covering of the brain. Neurological problems, blindness, and progressively worsening weakness and incontinence are also possible long-term problems. Many of these problems can be eliminated or minimized with timely diagnosis and proper treatment.
Doctors use a variety of tests to diagnose FAD in patients who show symptoms of a fistula. A murmur, an abnormal sound heard when listening to an artery with a stethoscope, is often the first indication to a doctor that a patient may have a FAD. If other, more common medical conditions have been ruled out, your doctor will likely order magnetic resonance imaging (MRI) tests or angiography, which allow doctors to see the inside of blood vessels, to confirm the diagnosis.
An operation performed by a specialized neurosurgeon is usually needed to treat a dural arteriovenous fistula. Open surgery involves the surgeon exposing the brain or spinal sheath and physically disconnecting the DAVF from the dura to minimize the risk of further complications. Endovascular surgery involves placing a small tube, called a catheter, into the arteries around the DAVF to deposit a resinous material, which destroys as much of the fistula as possible. This procedure can be done on its own or it can be done as a precursor to open surgery to make the procedure easier.
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