• Zhigang Yang, Yang Gao, Tengfei Liu, Chen Li, Jinlong Huang, Tao Xie, Liangliang Yang, Puyuan Zhao, and Xiaobiao Zhang.
• National Clinic Research Center for Interventional Medicine, Shanghai, China; Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai, China.
• World Neurosurg. 2022 Oct 1; 166: 228236.e1228-236.e1.

ObjectiveDural arteriovenous fistulas (DAVFs) in the falx cerebri are rare. This study presents a case of DAVF in the frontal falx cerebri that was successfully resected using a purely endoscopic keyhole microsurgical technique.MethodsA 69-year-old male patient presented to the emergency department with an acute onset seizure. His condition was diagnosed as a DAVF in the frontal falx cerebri with multiple fistula points. A purely endoscopic resection was performed under neuronavigation. Postoperative angiography and clinical follow-up were performed after 10 days and 3 months, respectively.ResultsThe DAVF was satisfactorily observed and resected using a purely endoscopic keyhole microsurgical technique, with no deterioration of neural functions or major vessel ruptures. Postoperative angiogram revealed complete obliteration of the DAVF and no recurrent epilepsy during the clinical follow-up.ConclusionsSupported by sufficient preoperative evaluation and meticulous manipulation,a purely endoscopic minimally invasive resection is feasible and safe for DAVF, with the advantages of close observation and panoramic view.Copyright © 2022 Elsevier Inc. All rights reserved.

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