11/14/2025
📣 New Publication — Neurosurgical Focus Video
🎥 Microsurgical Resection of a Scalp Arteriovenous Fistula With Intracranial Drainage
DOI: 10.3171/2025.7.FOCVID25109
We present a rare and complex scalp arteriovenous fistula (AVF) with intracranial drainage into the superior sagittal sinus, managed through a carefully planned microsurgical approach by our interdisciplinary neurovascular team.
What We Learned
• Intracranial venous drainage significantly increases risk, making embolization alone unsafe.
• Intraoperative Doppler and IV-DSA allow precise localization of feeding arteries and the draining emissary vein.
• Complete disconnection of the emissary vein is essential to prevent recurrence.
• When full-thickness scalp is involved, en bloc resection ensures safe and complete removal.
• Multidisciplinary evaluation—endovascular + microsurgical—provides the safest pathway.
• Every scalp AVF requires an individualized, anatomy-based strategy.
Outcome
The patient recovered without deficits, headaches resolved, and 2-year follow-up imaging confirmed complete cure with no recurrence.
Watch the video:
https://thejns.org/doi/abs/10.3171/2025.7.FOCVID25109
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