Dural arteriovenous fistulas (dAVFs) are rare, abnormal connections between arteries and veins in the dura, the protective lining of your brain. Having a dAVF can increase your risk of life-threatening complications, including brain hemorrhage, which can lead to a stroke.
At UPMC, our neurosurgery experts offer a full range of nonsurgical, minimally invasive, and traditional open surgical procedures to treat dAVFs. After diagnosing your condition, our neurosurgeons will develop a comprehensive treatment plan to reduce your risk of complications.
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Dural arteriovenous fistulas (dAVFs) are rare, abnormal connections between arteries and veins in the dura, the protective lining of your brain. Having a dAVF can increase your risk of life-threatening complications, including brain hemorrhage, which can lead to a stroke.
Doctors classify dAVFs based on the risks of complications, such as high blood pressure or bleeding in the brain. Types include:
A dAVF may occur spontaneously or as a result of:
In most cases, dAVFs happen spontaneously. However, you may be at increased risk of developing dAVF if you have:
If left untreated, dAVF can cause life-threatening complications, including:
You cannot prevent dAVF, but managing chronic conditions and making lifestyle changes to lower your risk of heart disease may lower your risk. Suggested lifestyle changes may include:
dAVF is a rare condition affecting less than 1 of 100,000 people each year.
Often, you may not know you have dAVF until it causes severe stroke symptoms. In some cases, dAVF is diagnosed during imaging testing for another condition.
Symptoms of dAVF can occur suddenly or gradually and may include:
A dAVF is life-threatening and needs emergency treatment. If you have symptoms of dAVF, dial 911 right away. Getting fast treatment can reduce your risk of disability and death.
To diagnose dAVF, your doctor will perform a physical exam and order imaging tests. Sometimes, dAVF is diagnosed during imaging testing for another condition.
When you arrive at the hospital, your doctor will:
Your doctor may order imaging tests to diagnose dAVF, including:
dAVF is a life-threatening condition. Your prognosis after dAVF will depend on the severity of your condition, whether it causes symptoms, and how quickly you receive medical care.
The goals of dAVF treatment are to reduce your risk of stroke and other complications. Treatment for dAVF depends on:
Treatment may include:
Endovascular embolization is a minimally invasive treatment. During embolization, your doctor will insert a thin, flexible tube called a catheter into an incision in your groin. Using x-ray imaging guidance, your doctor will guide the catheter to the dAVF. Your doctor will then use glue, coils or, most commonly, Onyx (an occlusive substance) to close off the fistula.
Gamma Knife radiosurgery is a safe, noninvasive treatment that uses highly focused radiation beams to precisely target and close the dAVF — reducing the risk of damage to nearby brain tissue.
Although stereotactic radiosurgery's effect isn't immediate, it can be an effective treatment option for people with low-risk dAVFs who can’t have endovascular embolization.
If you are not a candidate for an endovascular embolization or radiosurgery procedure, your doctor may recommend a procedure called craniotomy to treat your dAVF. It involves removing a piece of your skull to access your brain and “disconnecting” the dAVF.
When you choose UPMC for dAVF care, you will receive:
By UPMC Editorial Staff. Last reviewed on 2025-02-18.
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