Description:

This soundless video of surgery for repair of a right posterior fossa dural arteriovenous fistula (DAVF) shows clip ligation of its arterialized and venous components. The approach was via a right retrosigmoid craniectomy. This DAVF is fed by branches of the right AICA/PICA and drains into the superior petrosal sinus. The patient is a 60-year-old man who presented one day prior to surgery after experiencing sudden onset of severe headache and loss of consciousness. Head CT revealed diffuse subarachnoid hemorrhage and no hydrocephalus. Cerebral angiography disclosed a Borden III DAVF. Endovascular embolization of the fistula was considered, but felt to be technically infeasible. He tolerated the surgery very well and had no focal neurological deficits post-operatively. For additional reading, please refer to the following article. Narayanan, S. Endovascular Management of Intracranial Dural Arteriovenous Fistulas. Neurology Clinics: 28; November