Houston Methodist Hospital Neurological Institute Cerebrovascular Program offers expert diagnosis and treatment for dural and spinal fistulas.
Dural fistulas are abnormal connections between arteries, the outermost layer of the brain (dura), and a draining vein.
These connections can occur as a result of venous sinus blood clots or traumatic head injury. Depending on their location and size, these lesions may cause ringing in the ears, headache, or neurological deficits. Untreated, they can cause hydrocephalus and potentially devastating brain hemorrhage.
Cerebral angiography is the diagnostic test of choice to best evaluate a dural fistula.
Treatment options for these malformations include endovascular embolization, microsurgical resection, and focused stereotactic radiation. Some patients may require multiple treatments or a combination of treatments to completely eliminate the lesion.
A spinal dural fistula is an abnormal connection between a spinal artery and a draining vein, where the fistula itself is in the spinal dural root sleeve. Usually found in the lumbar or lower thoracic spine, patients may present with low back pain, loss of function from nerve compression, or hemorrhage.
Spinal angiography is the test of choice to best diagnosis and evaluate a spinal dural fistula. Each vessel supplying the spinal cord is selectively catheterized and imaged offering an extremely precise assessment of both the arteries and veins.
Treatment options include both transarterial and transvenous embolization and microsurgical resection, some patients require a combination of treatment modalities to obliterate the lesion and preserve motor function.