Dural arteriovenous fistulas associated with benign meningeal tumors

Background: Dural arteriovenous fistulas (dAVFs) are usually idiopathic lesions. While individual case reports have documented the occurrence of dAVFs in conjunction with benign meningeal tumors, a detailed characterization of this association is lacking. The objective of this study was to critically examine the relationship between benign meningeal tumors and dAVFs. Methods: We performed a retrospective review of records at two institutions, identified patients with coexisting benign meningeal tumors and dAVFs at the time of clinical presentation, and examined various clinical, anatomical and radiographic characteristics. Results: Ten patients (4.6 %) had coexisting benign meningeal tumors and dAVFs. The most common tumor was meningioma (90 %). Nine patients were symptomatic: Five from tumor, three from dAVF, and one from both tumor and dAVF. All dAVFs were related to the meningeal tumor. Conclusions: Benign meningeal tumors may be associated with dAVFs that are either in direct anatomical relation to the tumor or in distant anatomical locations. The increased propensity for development of dAVFs in patients with benign meningeal tumors may be due to multiple factors. Due to this association, additional imaging to exclude dAVFs could be considered in patients with meningeal tumors if exuberant vessels or flow voids are identified on routinely obtained magnetic resonance imaging scans.