Diagnosis and treatment of anterior skull base dural arteriovenous fistulas: A report of 26 cases

Abstract

Objective To investigate the diagnosis and treatment of dural arteriovenous fistulas (DAVFs) of anterior skull base. Methods The clinical data of 26 patients with DAVFs of anterior skull base admitted to Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from January 2011 to January 2019 were studied retrospectively. All the patients underwent operation through subfrontal approach. We focused on their clinical manifestations, imaging features and surgical methods. The therapeutic effects were evaluated by digital subtraction angiography (DSA) after operation and during follow-up. Results The fistulas of all 26 patients were successfully closed. Anosmia was reported in 2 cases and no other serious complications occurred. The complete obliteration of DAVFs was confirmed by postoperative DSA, and no recurrence was observed at follow-up ranging from 3 months to 9 years. Conclusion DSA seems to be an effective method for the diagnosis of anterior skull base DAVFs, for which microsurgical closure of fistulas is the effective treatment. Sufficient preoperative imaging evaluation, skilled microsurgical techniques, exact closure of fistulas are keynotes for the success of operation. Key words: Arteriovenous fistula; Skull base; Diagnosis; Treatment; Dural