Abstract
Results of radiosurgery for dural arterio-venous fistulas were reported. There are 24 cases, consisting of 16 males and 8 females, whose mean age was 59.5 years old. DAVFs were located in cavernous sinus (7), transverse-sigmoid sinus (6), cerebellar tent (5), anterior skull base (2), cranio-cervical junction (2) and others (2). Fistulas with a mean diameter of 13.3 mm (1.7 cc) were treated with the mean maximum and marginal dose of 35.2 Gy and 19.1 Gy respectively. Fistulas showed an early shrinkage and obliteration just same or faster than AVM. In fact complete (9) or nearly complete obliteration (9) were obtained with the mean follow-up period of 26.8 months. Neurological signs like chemosis in cavernous sinus cases, headache and tinnitus in transvers-sigmoid cases recovered much faster than lesional obliteration. Except for two rebleedings during latency period, no serious complications were not seen. Therefore, radiosurgery for DAVF is apparently effective and useful. However, such cases with progressive neurological signs and associated with cortical reflux shoud be treated first with endovascular or surgical procedures.
