In general, if complete occlusion of the cranial DAVF can be achieved without complications, the vascular malformation can be cured with good clinical outcome. Occasionally downgrading these malformations from Borden grade II-III to Borden I can be accepted as a valid treatment. That being said, cranial DAVFs should be considered dynamic lesions that can recur and progress. Thus, long term follow-up is mandatory. Occasionally, spontaneous resolution of cranial DAVFs has been reported.
Outcome after endovascular surgery and surgery
- Operative treatment outcomes: Endovascular therapy can cure these malformations in up to 70% of cases. In approximately 85% of cases the cortical venous drainage can be reversed(9). If endovascular treatment is not complete, surgery or radiosurgery can be used.
Outcome after non-surgical treatments
- Non-operative treatment outcomes: The effects of radiosurgery are delayed (up to 36 months) and obliteration rates have been reported to be around 55%–80%, some of them with the use of combined endovascular treatment(21,26).
Outcome after multimodal therapies
- Multi-modal treatment outcomes: With the use of multimodality treatment, rates of occlusion can be increased and morbidity/mortality can be decreased. Therefore, multispecialty team management is essential.