Intracranial Dural Arteriovenous Malformations: Results of Stereotactic Radiosurgery in 17 Patients

ABSTRACT: Aim: To assess the efficacy of stereotactic radiosurgery (STRS) for the treatment of dural arteriovenous fistulae (DAVF).Materials and methods: Between November 1987 and December 1998, 17 patients with a total of 18 DAVF were treated with STRS at the National Centre for Stereotactic Radiosurgery, Sheffield. Clinical and radiological data was collected retrospectively from the case notes and radiological records. Two neuroradiologists classified the pre-STRS appearance of the DAVF using the Borden criteria, and reviewed the follow-up imaging. Up to date follow-up was requested from the GPs and referring consultants.Results: In retrospect one DAVF had been misdiagnosed and was excluded from the study. The remaining 17 DAVF were located at the tentorium (6), cavernous sinus (3), right parasellar region (1), floor of left middle cranial fossa (1), midline posterior fossa (1), petrous apex (1) and transverse sinus (4). Ten were Borden type I, four were type II, three were type III. Follow-up angiography was available for 13 patients; 10 DAVF were completely obliterated, two showed considerable reduction in size, one showed deterioration. Clinical follow-up was available for 14 of the 16 patients.Conclusion: Stereotactic radiosurgery can successfully obliterate DAVF with few side effects. Copyright 2002 The Royal College of Radiologists. Published by Elsevier Science Ltd. All rights reserved. [Copyright &y& Elsevier]