Abstract
Galenic dural arteriovenousfistulas account for 1 of the 6 types of tentorial dural arteriovenousfistulas (type I). Thesefistulas are located around the great cerebral vein of Galen, with dural arterial supply through the tentorial arteries ofBernasconi and Cassinari or other posterior fossa branches, such as the posterior meningeal artery. In this case, a man inhis 60s presented with a headache and was found to have this high-risk lesion, which was Borden grade III and Cognardgrade IV. The lesion persisted despite embolization through the middle meningeal artery. This video discusses themicrosurgical management of this lesion through a torcular craniotomy and a posterior interhemispheric approach forclipping. Because this is a single case report, institutional review board approval was not needed. The patient consentedto the procedure. Used with permission from Barrow Neurological Institute, Phoenix, Arizona. Images at 7:19 and 7:49 inSurgical Video are used with permission from Lawton, Michael T.; Sanchez-Mejia, Rene O.; Pham, Diep; Tan, Jeffrey;Halbach, Van V. Tentorial Dural Arteriovenous Fistulae: Operative Strategies and Microsurgical Results for Six Types.Operative Neurosurgery 62(3): 110-125, 2008.