Intracranial haemorrhage in dural arteriovenous fistula.

I read the article by Brzozowski et al. about the percentage of intracranial haemorrhage in type I dural arteriovenous fistula with great interest [1]. In the paper, the authors demonstrated that 50% of patients with dural arteriovenous fistula presented with intracranial haemorrhage. However, the results of the paper were not concordant with the already published data in some larger studies (n = 236-1075), which have demonstrated a risk of intracranial haemorrhage between 12% and 23.7% [2-5] (Table 1). In the paper published by Li et al., only two cases out of the reported 91 with Borden type I (Cognard type I and type IIa) dural arteriovenous fistulas presented with an intracranial haemorrhage, as compared to 28.6% in the authors’ paper. The sample size of the study and the inclusion of only those patients who were managed with embolisation probably contributed to this discrepancy.

Table 1

Review of literature on the presence of intracranial haemorrhage in patients with dural arteriovenous fistula

Paper	Number of patients	% of patients presenting with haemorrhage	% of patients presenting with haemorrhage in Cognard type 1 dural arteriovenous fistula
Li et al.	236	23.7% (n = 56)	3.6% (n = 2)
Hiramatsu et al.	1075	12.0% (n = 129)	–
Piippo et al.	261	13.0% (n = 34)	–
Singh et al.	402	18.0% (n = 72)	–

Disclosure

The author declares no conflict of interests.