Imaging of Cerebral Arteriovenous Malformations and Dural Arteriovenous Fistulas

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General Features

Cerebral AVMs represent congenital vascular abnormalities, in which single or multiple arterial feeding vessels supply a dysplastic plexiform network of vessels (also known as the nidus) with direct shunting into the venous system. The nidus, which represents a conglomerate of dysplastic, thin-walled vessels, is histologically best characterized as a cluster of arterialized veins. The nidus can be supplied by one vascular distribution, or there can be supply from multiple vascular territories,

General Features

DAVFs make up 10% to 15% of intracranial vascular malformations,61 and are abnormal connections between dural arteries and dural venous sinuses, meningeal veins, or cortical veins. The etiopathogenesis remains to be fully elucidated, but DAVFs have been associated with history of trauma, previous craniotomy, or dural venous sinus thrombosis. In the setting of interrupted normal sinus outflow and elevated local venous pressures, it is hypothesized that tiny physiologic shunts may enlarge,62 or

Summary

Imaging of cerebral AVMs and DAVFs is central to the diagnosis, proper characterization, and evaluation of these lesions. Imaging is helpful in pretreatment planning as well as posttreatment evaluation for residual arteriovenous shunting. DSA remains the gold standard for evaluation of AVM and DAVF, and CBCT is providing improved 3D evaluation. CT and MRI applications are complementary, and provide useful information relating to the association of the vascular lesions to the surrounding

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