Zyck Stephanie, De Jesus Orlando, Gould Grahame C.
SUNY Upstate Medical University
University of Puerto Rico, Medical Sciences Campus, Neurosurgery Section
Dural arteriovenous fistulas (dAVF) are vascular abnormalities in which arteries arising from branches of the carotid or vertebral arteries drain directly into the dural leaflets of the venous sinuses. They are sometimes referred to as dural arteriovenous malformations. Their location is more commonly supratentorial than infratentorial. The transverse-sigmoid junction is the most common location, with a slight left-sided predominance. They can also be found at tentorial, petrosal, ethmoidal, Sylvian, cavernous sinus, spinal dura, and superior sagittal sinus locations. When located in the cavernous sinus, they are referred to as carotid-cavernous fistulas. The clinical behavior of dAVFs, including the risk of intracranial hypertension and hemorrhage, predominantly depends on the venous drainage patterns. Cortical venous drainage predisposes to a more aggressive clinical course. Tentorial location is associated with most aggressive behavior, followed by Sylvian/middle fossa and ethmoidal/anterior fossa locations. The Borden and Cognard classifications are the most well-known classification systems used for predicting the aggressiveness of dAVFs.
硬脑膜动静脉瘘（dAVF）是一种血管异常，其中起源于颈动脉或椎动脉分支的动脉直接引流至静脉窦的硬脑膜小叶。它们有时被称为硬脑膜动静脉畸形。其位置幕上比幕下更常见。横窦-乙状窦交界处是最常见的位置，稍偏左侧。它们也可位于小脑幕、岩骨、筛窦、外侧裂、海绵窦、脊髓硬膜和上矢状窦部位。当位于海绵窦时，它们被称为颈动脉海绵窦瘘。dAVF的临床行为，包括颅内高压和出血风险，主要取决于静脉引流模式。皮质静脉引流易导致更具侵袭性的临床病程。小脑幕位置与最具侵袭性行为相关，其次是外侧裂/中颅窝和筛窦/前颅窝位置。Borden和Cognard分类是用于预测dAVF侵袭性的最著名分类系统。
