A case of dural arteriovenous (AV) fistula is presented with detailed radiological and pathological findings. The complex hemodynamic alterations that may result from dural AV fistulas are described. Pathological examination in this case demonstrated widespread occlusion of the superior sagittal sinus with multiple abnormal fistulous communications between abnormal arteries and arterialized veins. A portion of the lesion resembled a recanalized blood clot, in support of the theory proposed by others that dural AV fistulas are acquired lesions.