Neurosurgical Review

, Volume 36, Issue 3, pp 429–435 | Cite as

Surgical treatment of tentorial dural arteriovenous fistulae located around the tentorial incisura

  • Taketo Hatano
  • Oliver BozinovEmail author
  • Jan-Karl Burkhardt
  • Helmut Bertalanffy
Original Article


Tentorial dural arteriovenous fistulae (DAVF) are relatively uncommon and are the most dangerous type of DAVF. Because of a high incidence of hemorrhage and subsequent neurological deficits, treatment is mandatory. A consecutive series of nine surgically treated patients with symptomatic tentorial DAVF were analyzed in this study. All lesions were located around the tentorial incisura and were treated microsurgically using a subtemporal approach in eight cases and a supracerebellar approach in one case. The dural bases of the lesions were located adjacent to the tentorial edge in six patients and the tentorial apex in three patients. Complete obliteration was achieved in all treated tentorial DAVF. In one patient, the torcular fistula remained untreated without cortical venous reflux. Postoperative asymptomatic temporal lobe hemorrhage was diagnosed in one patient with a tentorial apex DAVF; however, no new neurological symptoms were present after surgical treatment. The subtemporal approach for unilateral tentorial DAVF is a favorable and direct approach for the highly skilled surgeon. Perimesencephalic venous dilatation or varix is an important finding on MRI to help localize tentorial DAVF in the tentorial edge or apex.


Dural arteriovenous fistulae (DAVF) Microsurgery Tentorial incisura Treatment Subtemporal approach 



No funding or industrial financial support was received for this study.

Supplementary material

Supplemental Video 1

Video of patient 1 demonstrating the clipping of the DAVF draining vein via a subtemporal approach, 1:03 min, 20.2 MB. (MP4 5418 kb)

Supplemental Video 2

Video of patient 6 demonstrating clipping of the DAVF draining vein via a subtemporal approach, 2:43 min, 91.5 MB. (MP4 16587 kb)

Supplemental Video 3

Video of patient 7 demonstrating clipping of the DAVF draining vein via a subtemporal approach, 1:50 min, 34.5 MB. (MP4 10729 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Taketo Hatano
    • 1
  • Oliver Bozinov
    • 2
    Email author
  • Jan-Karl Burkhardt
    • 2
  • Helmut Bertalanffy
    • 3
  1. 1.Department of NeurosurgeryUniversity HospitalKyotoJapan
  2. 2.Department of NeurosurgeryUniversity Hospital ZürichZürichSwitzerland
  3. 3.Department of Neurosurgery, International Neuroscience InstituteHannoverGermany

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