Clinical and radiological response of benign dural arteriovenous fistula (DAVF) after stereotactic radiotherapy

Dural arteriovenous fistulas (DAVF) are abnormal communication at the dura between dural arteries and dural venous sinus or veins. The transverse or sinus are common location of the shunt. This study retrospective investigated the clinical and radiological responses of benign DAVF patients following hypofractionated SRT (HSRT). Eight patients who were diagnosed benign DAVF were treated with HSRT during January 2015 to December 2022. Eight patients (75% female, 25% male) with benign DAVF, predominantly located in the transverse-sigmoid sinus, were treated with HSRT. The cohort had an average age of 52.75 years. All patients presented with pulsatile tinnitus, with one also experiencing headaches. Complete symptomatic recovery was observed in 75% of patients within a mean of 9.7 months post-HSRT. Partial recovery was reported in 25% of patients. Radiographic obliteration was achieved in 85.7% of patients within a mean of 22.3 months, with one patient exhibiting stable disease. Focal alopecia and hyperintense changes on imaging were reported as transient side effects. HSRT provide effective and safety result for symptomatic recovery and radiological obliteration in benign DAVF at transverse sigmoid location. This method provides minimally invasive therapeutic treatment option for patient who suffer from pulsatile tinnitus.