Letter by Gross and Du Regarding Article, “Intracranial Dural Arteriovenous Fistulae: Clinical Presentation and Management Strategies”

Abstract

We read with interest the review by Miller and Gandhi1 on dural arteriovenous fistulae (dAVF). Limited by word count of a letter to the editor, we cannot provide more references/details; however, we have several inquiries. The authors state that dAVF may recruit pial arterial supply. Do they have a radiographic example of such a case? It would seem almost by definition that dAVF are supplied exclusively by meningeal arteries. Perhaps a pial arteriovenous fistula or arteriovenous malformation may be of mixed supply, but it is difficult to understand from a pathophysiologic basis that how a dAVF may recruit pial arterial supply. The authors credit an article in Neurosurgery from 1984 as one of the first to identify cortical venous drainage as the main risk factor for serious sequelae from dAVF. In their oft-cited 1972 article in Radiology , …