DURAL ARTERIOVENOUS SHUNTS (DAVS)

Q1 What is DAVS?

Dural AVS is direct connection between brain dural arteries and veins through abnormal bunch of vessels. It drains into cerebral veins. So arterial pressure from dural arteries is directly transmitted to cerebral veins causing venous hypertension.

Q2 How patients with DAVS presents?

Patients with DAVS presents with:
1. Intracranial hemorrhage
2. Focal neurological deficit
3. Venous hypertension and raised intracranial pressure
4. Seizures

Q3 What are indications for treating DAVS?

All DAVS should be treated.

Q4 How to treat DAVS?

Endovascular embolization is treatment of choice.

Q5 How DAVS embolization is done?

Step 1: Femoral artery is punctured and sheath is placed in femoral artery. Then through it guiding catheter (green) is placed into neck vessel.<.strong>

Step 2: Microcatheter (yellow) is taken through guiding catheter in the feeding artery.

Step 3: DAVS is embolized with liquid embolic agent.

Step 4: Finally microcatheter, guiding catheter and sheath are removed.

CASE: 42yrs male with posterior fossa haemorrhage and Dural AV Shunt