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Arteriovenous Fistula (AVF)

About Arteriovenous Fistulas (AVFs)

Normally, blood flows from the arteries to the veins through the capillaries. However, sometimes blood flows in one spot from the artery directly to the vein. This abnormal channel is called an arteriovenous fistula (AVF). An arteriovenous fistula can occur anywhere in the body, but requires specialized care if it is near the brain or spinal cord. AVF causes pressure to increase at the site and, without treatment, can damage spinal function or impair normal blood circulation to the brain. It can also bleed.

Doctors sometimes call AVFs near the brain DAVFs, or dural arteriovenous fistulas, named after the covering around the brain where the AVF is located. You may also hear the acronyms SDAVF (Spinal Dural Arteriovenous Fistula) or BDAVF (Brain Dural Arteriovenous Fistula).

Symptoms of an Arteriovenous Fistula (AVF)

If you have a brain AVF, you may have had some frightening symptoms or none at all. BDAVFs may cause the following:

  • Rumbling, “to-and-fro” sound in one ear in time with your heartbeat
  • Redness and swelling of one or both eyes
  • Seizures
  • Strokes
  • Headache
  • Fatigue
  • Memory loss
  • Concentration problems
  • Psychiatric problems
  • Hallucinations

Seizures and strokes generally occur only when the fistula has become large enough to increase pressure around the brain. Symptoms such as headache, fatigue, memory loss or lack of concentration can occur at any stage.

If you have a spinal AVF, you may have experienced symptoms caused by swelling near the spinal cord. SDAVF symptoms include:

  • Back pain
  • Leg pain, weakness or stiffness
  • Urinary problems, such as difficulty urinating and emptying the bladder
  • Bowel problems, such as constipation
  • Impotence

Because the initial symptoms of brain and spinal AVFs are not specific, many people experience a delayed diagnosis.

Diagnosing an Arteriovenous Fistula (AVF)

Currently, the best way to diagnose an AVF is by using a technique called catheter cerebral angiography. During this procedure, a small, hollow tube, called a catheter, is inserted into one of your arteries in your groin. The doctor injects a dye through the catheter and examines your arteries on an x-ray. An angiogram can take about one hour, but your care team may ask you to stay in the hospital for several hours after the test.

Treatment Options for an Arteriovenous Fistula (AVF)

Your neurosurgeon probably wants to close your AVF before it results in permanent damage. He or she will discuss treatment options with you. They include catheter embolization and/or microsurgical resection.

Catheter embolization uses a procedure similar to the angiogram. The doctor guides a catheter through your arteries or veins to the site of the AVF. At the site, the doctor uses medical glue or a specialized device to close the fistula. This treatment option is effective for most people.

Microsurgical resection involves the surgical closure of the AVF. If you have an AVF near your brain, the surgeon may perform a craniotomy as part of this procedure. A craniotomy is the removal of part of the skull to expose the brain in order to access the appropriate tissues for repair.

As a patient, you should always feel comfortable asking questions of your care team about the various treatment options and which one may be right for you.

Why Choose Neurosurgeons of New Jersey?

When you seek medical treatment for an AVF, it is important to research all of your available options. Many medical professionals may be experienced and qualified, but do not offer the premium level of care you need to ensure your health is put first.

Neurosurgeons of New Jersey has the largest sub-specialized practice in the tri-state area. Many of our surgeons come from the renowned Columbia University Medical Center. Neurosurgeons of New Jersey is also part of the Neurological Institute of New York, an institution that has stood and been respected for 100 years.

We practice using cutting-edge technology and honor our philosophy of patient-centered care. As a patient, you are unique. Your experience with AVF and the treatment we provide will depend on your own medical history and the site and complications of your case. To give yourself the best chance of a successful treatment, take the time to research your condition and speak with your doctor about the best options available for your care.

Our Doctors Who Treat Arteriovenous Fistulas

Dr. Gaetan Moise


Dr. Dorothea Altschul


Dr. Ahsan Sattar


Dr. Bree Chancellor