Diagnosis of DAVF
Diagnosing a dural arteriovenous fistula (DAVF) is a step-by-step process that involves various tests and examinations. The goal is not only to confirm the presence of a DAVF, but also to understand its size, location, and the precise pattern of abnormal blood flow. This helps us formulate a suitable treatment plan.
Medical History and Physical Examination
The first step involves a thorough review of your medical history. We will ask you detailed questions about your symptoms, including their nature, duration, and severity. We may also ask you about your overall health, including any other medical conditions you may have and any medications you are currently taking.
Imaging Tests
Several types of imaging tests can help visualize the blood vessels in the brain and detect any abnormalities. These include:
Computed Tomography (CT): A CT scan uses X-ray technology to capture images from various angles, creating cross-sectional views of the brain. These can reveal abnormalities or changes in the brain that might be indicative of a DAVF. Additionally, a CT scan can be combined with angiography (CTA) to provide detailed images of the blood vessels, enhancing the visualization of a possible DAVF.
Magnetic Resonance Imaging (MRI): An MRI is a non-invasive imaging technique that employs powerful magnets and radio waves to generate comprehensive images of the brain and spinal cord. These images can often highlight the presence of a DAVF or illustrate the impact it has on the brain or spinal cord. MRI can also be combined with angiography (MRA) to visualize blood vessels and the flow of blood, offering a detailed view of any abnormal vascular structures associated with DAVF.
Digital Subtraction Angiogram (DSA): DSA is a more invasive procedure that is often used when other imaging tests are inconclusive or when precise details of the blood vessels are needed for treatment planning. In this test, a contrast dye is injected into your blood vessels through a catheter, usually inserted in your groin. As the dye travels through your vessels, a series of X-ray images are taken, which can provide a clear, detailed view of the blood flow and reveal the exact location and characteristics of a DAVF. While more involved and with more potential risks than other imaging studies, DSA is considered the “gold standard” for diagnosing DAVFs due to its high level of detail.