Duke's Cerebrovascular Center offers expert diagnosis and treatment for dural fistulas.
Dural fistulas are abnormal connections between arteries in the brain and the outermost layer of the brain, or dura.
These connections can occur spontaneously, following trauma, or as a result of sinus blood clots.
Depending on their location and size, these lesions may cause ringing in the ears, neurological deficits, and can even predispose patients to potentially devastating brain hemorrhage.
At Duke, the goal of treatment is to disrupt the abnormal connection between the arteries and veins. We often use a combination of trans-arterial and trans-venous embolization to disrupt the connections.
In embolization, catheters are placed into the arteries feeding the fistula, and the veins draining the fistula. A combination of glue, onyx, and wire coils are used to block the abnormal connections.
Some patients may require multiple treatments or surgical treatment.
In surgical treatment, our specially trained surgeons perform a craniotomy, using a high-magnification operating microscope and microsurgical technique to identify the fistula. The surgeon then places metallic clips to block the arterial supply to the fistula.
The following images show how dural fistulas appear in the brain before and after treatment.
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