Surgical Management of Craniocervical Dural Arteriovenous Fistula

DAVFs of the craniocervical junction (CCJ) along the first spinal nerve are rare and a unique subtype of DAVFs at the CCJ. These fistulas account for 1–2% of all intracranial and spinal DAVFs. SAH is the major manifestation of DAVFs at C1 spinal nerve that may be overlooked on routine initial DSA. Rotational CT angiography is useful for clarification of the angioarchitecture of these fistulas, including small feeding artery and venous varix. Surgical treatment by interruption of the intradural draining vein should be the treatment of choice for C1 spinal nerve DAVF.