Falcotentorial Location of Dural Arteriovenous Fistulas Derived from the Neural Crest as a Risk Factor for Aggressive Clinical Course

  • Michihiro Tanaka
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 129)


The topographical distribution of dural arteriovenous fistulas (DAVFs) was analyzed based on the embryological anatomy of the dural membrane. Sixty-six consecutive cases of intracranial and spinal DAVFs were analyzed based on the angiography, and each shunt point was identified according to the embryological bony structures. The area of dural membranes was categorized into three different groups: a ventral group located on the endochondral bone (VE group), a dorsal group on the membranous bone (DM group), and a falcotentorial group (FT group) in the falx cerebri, tentorium cerebelli, falx cerebelli, and diaphragma sellae. The FT group was derived from the neural crest and designated when the dural membrane was formed only with the dura propria (meningeal layer of the dura mater) and not from the endosteal dura. Olfactory groove, falx, tent of the cerebellum, and nerve sleeve of spinal cord were categorized in the FT group, which presented later in life and which had a male predominance, more aggressive clinical presentations, and significant cortical and spinal venous reflux. The FT group was formed only with the dura propria that was considered as an independent risk factor for aggressive clinical course and hemorrhage of DAVFs.


Dorsal mesoderm Dura propria Dural arteriovenous fistulas Endochondral bone Membranous bone Neural crest Paraxial mesoderm 



Computed tomography


Dural arteriovenous fistulas

DM group

Dorsal membranous bone group


Digital subtraction angiography

FT group

Falcotentorial group


Magnetic resonance imaging

VE group

Ventral endochondral group



The author thanks Dr. Giuseppe Esposito and Prof. Tetsuya Tsukahara for their proposal and organization to publish this chapter.

Conflicts of interest disclosure: The author reports no conflict of interest concerning the materials or methods used or the findings specified in this study.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Michihiro Tanaka
    • 1
  1. 1.Department of NeurosurgeryKameda Medical CenterKamogawaJapan

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