Dural arteriovenous fistulas

Dura is a part of the 3 layercovering of the brain.Dural arteriovenous fistulas are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Dural AV fistula arise in situations where there is dural sinus occlusion , sinuses are venous structures which drain blood away from the brain towards the heart. Individuals who have a propensity to develop blood clots( hypercoagulant state), auto-immune disorders, malignancies, chronic infections are at risk of developing dural AV fistula. There are various angiogenic factors that are released which give rise to connections between the arterial to venous system giving rise to fistulae. They usually present with severe unrelenting throbbing headache. Other symptoms could include from a bleed in a brain, fluctuating hand or leg weakness to fits. Digital subtraction angiography remains the gold standard for diagnosing these fistulas. Endovascular treatment is one of the first line options available for their management. The plan and route of treatment is decided based on the type of fistula characterised by various scoring systems.