Abstract
A cranial dural arteriovenous fistula may undergo configurational changes in response to local arterial pressure. A 53-year-old man had two distinct neurosurgical pathological features at presentation: an occipital dural arteriovenous fistula and cervical radiculopathy secondary to spondylosis. An anterior cervical discectomy and fusion were performed with the patient's head secured to a horseshoe headrest. After surgery, the patient's bruit resolved, and angiography demonstrated involution of the cranial dural arteriovenous fistula with only a small residual arteriovenous shunt. Sustained local pressure on the scalp may produce favorable symptomatic and angiographic changes in cranial dural arteriovenous fistulae.
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