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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1259-1262, May 2005
© 2005 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Cerebral Arteriovenous Fistulas Induced by Dural Arteriovenous Shunts

C. W. Lai^a, R. Agid^b, R. van den Berg^c and K. ter Brugge^b

^a Department of Radiology, Hong Kong Baptist Hospital, Hong Kong, China
^b Division of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, Canada
^c Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands

Address correspondence to Professor K. ter Brugge, Division of Neuroradiology, Toronto Western Hospital, Fell Pavillion 3-210, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada

Summary: Dural arteriovenous shunts and pial arteriovenous fistulas are uncommonly associated. Their etiology, pathogenesis, and natural history are still unclear and are likely different. We present three cases of high-flow dural arteriovenous shunts associated with pial arteriovenous fistulas and discuss their pathogenesis, anatomic association, and angioarchitecture. We propose that venous steal effect in the dural sinus secondary to the high-flow dural arteriovenous shunt induced the pial arteriovenous fistulas. Treatment of the high-flow dural arteriovenous shunts and the induced pial arteriovenous fistulas are discussed.