Cranial dural arteriovenous fistulas

<jats:title>Abstract</jats:title> <jats:p>This chapter provides an extensive review of cranial dural arteriovenous fistulas (DAVFs), encompassing their aetiology, imaging characteristics, classification systems, clinical presentation, natural history, and treatment approaches. It begins with pathophysiological mechanisms and epidemiological data, then discusses cross-sectional and catheter-based imaging modalities including computed tomography, magnetic resonance imaging, computed tomography angiography, magnetic resonance angiography, and digital subtraction angiography. The chapter outlines the Cognard, Borden, and Barrow classifications, focusing on cortical venous reflux as a key determinant of lesion aggressiveness. Indications for conservative and interventional management are delineated based on DAVF type and symptomatology. Endovascular treatment principles are described in detail, including both transarterial and transvenous techniques, with discussion of embolic agents, catheter selection, and procedural strategies. Complications specific to DAVF treatment are reviewed. Dedicated sections cover fistulas in specific common anatomical regions, including the transverse and sigmoid sinuses, superior sagittal sinus, tentorium, lateral foramen magnum, anterior cranial fossa, and cavernous sinus. Both indirect and direct carotid–cavernous fistulas are addressed, with emphasis on anatomical considerations, imaging, and technical approaches.</jats:p>