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Neurosurg Focus. 2016 Jan;40 Video Suppl 1:2016.1.FocusVid.15420. doi: 10.3171/2016.1.FocusVid.15420.

Microsurgical treatment of a tentorial galenic dural arteriovenous fistula.

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Stanford University Medical Center, Department of Neurosurgery, Stanford, California.


Tentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemorrhage and multitude of feeders. We describe the case of a 65-year-old male who presented with hemorrhage from a straight sinus and galenic TDAVF. The straight sinus portion of the fistula was obliterated by 3 endovascular treatments and 1 microsurgical treatment. The galenic component of the TDAVF persisted and was approached via a posterior interhemispheric approach in a lateral position. This video demonstrates surgical technique and anatomy associated with this rarely seen dural arteriovenous fistula. The video can be found here: .


dural arteriovenous fistula; galenic fistula; microsurgery; supracerebellar infratentorial; tentorial fistula; tentorial incisura; vein of Galen; video

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