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Dural arteriovenous fistulas (dAVFs) are rare vascular anomalies accounting for 10-15% of intracranial vascular malformations, where arteries connect directly to veins within the dura mater. Unlike brain AVMs, they lack a nidus and are often acquired, with symptoms like pulsatile tinnitus, headaches, or hemorrhage. Radiopaedia Radiopaedia +3 Key Aspects of Dural Fistulas (dAVFs) Definition & Location: Abnormal connections between meningeal arteries and dural sinuses/veins, most commonly at the transverse-sigmoid sinus junction. Causes: Often acquired, frequently following thrombosis, trauma, or surgery. Symptoms: Commonly include pulsatile tinnitus (rushing noise in ear), vision changes (red eyes/proptosis), and headaches. Diagnosis: Digital subtraction angiography is the gold standard, though CT/MRI can suggest the diagnosis. Treatment: Endovascular embolization (glue/onyx), surgical resection, or radio-surgery. National Center for Biotechnology Information (.gov) National Center for Biotechnology Information (.gov) +4 Dural Fistula vs. Brain AVM Location: dAVFs are in the dura (outer covering); AVMs are within the brain parenchyma (brain tissue). Structure: dAVFs have direct connections; AVMs have a tangled “nidus”. Flow: dAVFs often cause higher venous pressure leading to venous congestion.