Dural arteriovenous fistulas and the neurology of venous hypertension

Dural arteriovenous fistulas (DAVFs) represent important, often misdiagnosed causes of neurological dysfunction. Because these lesions do not always present with "stroke-like" syndromes, the vascular etiology of some DAVF symptoms may not be recognized. In addition, DAVFs cause focal neurological dysfunction remote from the location of the nidus, which also leads to diagnostic confusion. Noninvasive neuroimaging has made diagnosis easier, but neurologists must maintain a high index of suspicion to avoid overlooking these treatable lesions. This article reviews the pathophysiology and clinical presentations of DAVFs affecting the eye, spinal cord, and brain.