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Cranial & Spinal Dural Fistulas

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Houston Methodist’s internationally recognized neurologists offer advanced diagnosis and personalized treatment for cranial and spinal dural fistulas.

Cranial dural fistulas, also called cranial dural arteriovenous fistulas (dAVFs), are abnormal connections between arteries, a draining vein and the dura, which is the outermost layer of the brain. They can form due to blood clots in the venous sinus or a traumatic head injury. If left untreated, these conditions can cause hydrocephalus, which is excess fluid in the ventricles of the brain. 

Houston Methodist neurologists and neurosurgeons are specialty trained in the diagnosis and treatment of cranial and spinal dural fistulas. Using the latest scientific research and advanced treatments, we provide personalized treatment for these rare, serious conditions. 

Diagnosing & Treating Cranial & Spinal Dural Fistulas 

How are cranial and spinal dural fistulas diagnosed?

Cerebral angiography helps our specialists diagnose cranial dural fistulas. This procedure uses a contrast dye and X-rays to see how blood flows through the brain. For spinal dural fistulas, spinal angiography shows a precise view of the arteries and veins. Each vessel supplying the spinal cord is selectively catheterized and imaged. MRI and CT can also support diagnosis. 

Symptoms of cranial dural fistula depend upon the location and size of the fistula. Patients often describe symptoms such as headache, vision problems, ringing in the ears and neurological deficits. 

Spinal dural fistulas may not cause any symptoms until they enlarge or cause swelling in the spinal cord. When symptoms do appear, they may include: 

  • Bladder and bowel problems 
  • Erectile dysfunction 
  • Lower back pain
  • Pain, weakness, stiffness, numbness or burning in the legs 

 
Spinal dural fistulas cause blood congestion and higher pressure in the spinal cord. This can cause swelling and dysfunction, including irreversible vein damage and possible paralysis. There is no known cause for most spinal dural fistulas, although some may be caused by previous surgeries or trauma to the area. Anyone can develop a spinal dural fistula, but they are most common in men ages 50 and older.

What treatments are available? 

Many fistulas can be cured and do not recur. Treatment options must be personalized to the patient and may include: 

  • Endovascular or transarterial embolization 
  • Focused stereotactic radiosurgery 
  • Microsurgical resection 

 
Some patients need a combination of treatments to repair the fistula and preserve motor function. The specific recovery and rehabilitation period depends on each patient, and the location and severity of the fistula. 

What if I need advanced care or a second opinion?

Whether you need a precise diagnosis or a second opinion, we can help. Our specialists can pinpoint the cause of your symptoms and design a personalized treatment plan to restore your quality of life.

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