• Neurosurg Focus · Jan 2016

    Case Reports

    Microsurgical treatment of a tentorial galenic dural arteriovenous fistula.

    • Omar Choudhri and Gary K Steinberg.
    • Stanford University Medical Center, Department of Neurosurgery, Stanford, California.
    • Neurosurg Focus. 2016 Jan 1; 40 Video Suppl 1: 2016.1.FocusVid.15420.

    AbstractTentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemorrhage and multitude of feeders. We describe the case of a 65-year-old male who presented with hemorrhage from a straight sinus and galenic TDAVF. The straight sinus portion of the fistula was obliterated by 3 endovascular treatments and 1 microsurgical treatment. The galenic component of the TDAVF persisted and was approached via a posterior interhemispheric approach in a lateral position. This video demonstrates surgical technique and anatomy associated with this rarely seen dural arteriovenous fistula. The video can be found here: https://youtu.be/iOLzWOabLZ0 .

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