Cerebral Arteriovenous (AV) Fistula
A cerebral arteriovenous fistula (AVF) is an abnormal direct connection of intracranial arteries and vein without intervening capillaries. Cerebral AV fistulas include dural AVFs, caroticocavernous fistulas (CCFs), vein of Galen malformations and pial AVFs. The clinical presentation of a cerebral AVF varies according to the site and magnitude of the fistula. A CT scan, MRI, CTA, MRA and DSA are the necessary investigation methods for diagnosis, classification and management purposes. The mainstay of treatment is an endovascular occlusion. A microsurgical occlusion or excision is needed when the endovascular procedure fails or is not possible. Here, the pathology, classification, clinical presentation and management of dural AVFs, vein of Galen malformations and pial AVFs are discussed. CCFs will be discussed in Chapter 15.
