How to treat the intervention of dural arteriovenous fistula in the dome margin area

  Dural Arteriovenous Fistula (DAVF) is an abnormal arteriovenous traffic in the dura mater and its appendages, the falx and the cerebellar curtain, often secondary to venous sinus obstruction, and is an acquired disease that accounts for 10%-15% of intracranial vascular malformations. DAVF is mainly supplied by the external carotid artery, and the meningeal branches of the internal carotid artery and vertebral artery can also be involved in blood supply, and the transverse and sigmoid sinuses are most vulnerable, followed by the cavernous sinus and superior sagittal sinus.  Features of dural arteriovenous fistula: It is located in the dural margin area and accounts for 8% of the intracranial DAVF.  Blood supply arteries: middle meningeal artery (MMA) and meningohypophyseal trunk (MHT) are predominant.  Drainage veins: lateral middle meningeal artery —-> straight sinus —-> transverse sinus —-> ethmoid sinus Clinical symptoms: 1. may be asymptomatic; 2. hemorrhage (58-74%); progressive neurological impairment (pressure symptoms, hydrocephalus, trigeminal neuralgia 79-92%,).  DAVF staging (Congard IV/Bordon III) in the area of the antennal rim with high risk of bleeding.  Procedure: microsurgery or interventional procedures (arterial access and venous access) Presentation of case: interventional treatment of DAVF in the area of the anterior curvilinear margin with simple meningeal pituitary trunk supply.