Intracranial dural arteriovenous fistulas: endovascular therapy.

Dural arteriovenous malformations are probably acquired lesions, and therefore the term dural arteriovenous fistula (AVF) is more appropriate. Dural AVFs generally present with symptoms related to their venous drainage. Common indications for treatment include hemorrhage, progressive neurologic deficit, and intractable tinnitus. Endovascular therapy is preferred in the majority of cases, although certain locations warrant direct neurosurgical or combined techniques. Endovascular therapy of dural AVFs may be taxing for both patient and endovascular therapist. More than one treatment session employing both arterial and venous approaches may be required.