Combined endovascular-microsurgical treatment of tentorial-incisural dural arteriovenous malformations. Report of five cases.

Dural arteriovenous malformations of the tentorial edge are rare lesions with an unfavorable clinical course if left untreated. As yet no optimum treatment has been established. We retrospectively evaluated the results of our therapy concept, which consists of endovascular embolization followed by microsurgical obliteration, and compared the results to the relevant literature in order to clarify which therapeutic regimen seems to be optimum at the present time. In all of our five patients the lesion was completely obliterated, as proven by angiography, with favorable clinical results and low morbidity. Several other clinical series confirm our results, so we conclude that combined endovascular therapy and microsurgery is the optimum treatment for these lesions.