# Microsurgical Management of Craniocervical Dural Arteriovenous Fistula: A Case Report and Literature Review

## TL;DR

This paper presents a case of a rare craniocervical dural arteriovenous fistula successfully treated with microsurgery using intraoperative angiography.

## Contribution

The paper introduces microsurgical obliteration with intraoperative angiography as a feasible treatment for craniocervical DAVF.

## Key findings

- Microsurgical obliteration of the draining vein was successfully performed using intraoperative digital subtraction angiography.
- Craniocervical DAVF is rare and requires detailed angioarchitectural evaluation for optimal treatment.
- The patient had a good outcome following the microsurgical procedure.

## Abstract

Dural arteriovenous fistula (DAVF) of the craniocervical junction is exceptionally rare. The anatomy of the craniocervical junction area is very complex and is composed of the medulla and spinal cord along with intricate neurovascular structures. A thorough assessment of the angioarchitecture of the fistula is obligatory for choosing the most appropriate treatment for the patient. In this report, we describe the nuance of microsurgical obliteration of craniocervical junction DAVF utilizing intraoperative angiography.

A 38-year-old male in a normal state of health was referred to our hospital for an abnormality in his brain checkup. Workup diagnostics showed a DAVF on the craniocervical junction area with feeders from ascending pharyngeal, vertebral, and occipital arteries, with the draining vein mainly to the basal vein of Rosenthal. Microsurgical obliteration of the main draining vein was done with the help of intraoperative digital subtraction angiography with a good outcome.

Craniocervical DAVF is a rare entity. Meticulous evaluation of arterial and venous fistula points is necessary to decide the best treatment option for this case. Microsurgical obliteration is a feasible and more straightforward procedure for treating craniocervical DAVF.