Endovascular Management of Intracranial Dural AVFs: Principles

AJNR Am J Neuroradiol. 2022 Feb;43(2):160-166. doi: 10.3174/ajnr.A7304. Epub 2021 Oct 21.


Intracranial dural AVFs are abnormal communications between arteries that supply the dura mater and draining cortical veins or venous sinuses. They are believed to form as a response to venous insults such as thrombosis, trauma, or infection. Classification and management are dependent on the presence of drainage/reflux into cortical veins because such drainage markedly elevates the risk of hemorrhage or venous congestion, resulting in neurologic deficits. AVFs with tolerable symptoms and benign drainage patterns can be managed conservatively. Intolerable symptoms, presentation with hemorrhage/neurologic deficits, or aggressive drainage patterns are indications for intervention. Treatment options include microsurgical disconnection, endovascular transarterial embolization, transvenous embolization, or a combination. This is the first in a series of 3 articles on endovascular management of intracranial dural AVFs, in which we outline the principles and outcomes of endovascular treatment.

Publication types

  • Review

MeSH terms

  • Central Nervous System Vascular Malformations* / diagnostic imaging
  • Central Nervous System Vascular Malformations* / surgery
  • Cerebral Angiography
  • Drainage
  • Dura Mater / blood supply
  • Dura Mater / diagnostic imaging
  • Dura Mater / surgery
  • Embolization, Therapeutic*
  • Endovascular Procedures*
  • Humans
  • Veins