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Updated: Feb 16, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
A multi-institutional analysis of the untreated course of cerebral dural arteriovenous fistulas
Bradley A Gross1,2, Felipe C Albuquerque3, Cameron G McDougall4
11UPMC Stroke Institute.
Insights
Understanding untreated cerebral dural arteriovenous fistulas is crucial. Drainage patterns and prior neurological events significantly predict future risks, aiding in better patient management and hemorrhage prevention.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Cerebral dural arteriovenous fistulas (cDAVFs) are abnormal connections between dura mater arteries and veins.
- The natural history and risk factors for neurological events in untreated cDAVFs require further elucidation.
Purpose of the Study:
- To delineate the natural course of untreated cerebral dural arteriovenous fistulas.
- To identify predictors of neurological events and hemorrhage in patients with cDAVFs.
Main Methods:
- Retrospective analysis of 295 untreated cerebral dural arteriovenous fistulas.
- Assessment of fistula characteristics, including drainage patterns and presenting symptoms.
- Evaluation of neurological events and hemorrhage as outcomes.
Main Results:
- Fistula drainage pattern was the most significant predictor of future neurological events or bleeding.
- Prior neurological events or hemorrhage independently increased the risk of subsequent events.
- Hemorrhage rates were stratified across different subclasses of cDAVFs.
Conclusions:
- Drainage patterns are critical for risk stratification in untreated cDAVFs.
- Patients with a history of neurological events or hemorrhage are at higher risk.
- This study provides valuable data for managing untreated cDAVFs and preventing complications.
Abstract:
The authors attempted to better delineate the natural course of untreated cerebral dural arteriovenous fistulas. For a group of 295 fistulas, drainage pattern was most important in predicting the risk of future neurological events or bleeding. Moreover, presentation with a neurological event or hemorrhage was an independent risk factor for future neurological events or hemorrhage, respectively. The authors provided hemorrhage rates for various subclasses of dural arteriovenous fistulas to facilitate risk stratification, excluding partially treated lesions.
