Stopping Cortical Venous Drainage?

Hi! My husband has a large and complex Dural AVM/ Fistula and has been treated with 3 prior embolizations and had Linac SRS in February. We had thought that his cortical venous drainage was obliterated, but his 6 month post SRS MRI indicated reoccurring drainage. He had a diagnostic angiogram last week where they found drainage on both sides. Thankfully, they were able to embolize 2 arteries on the left, totally eradicating that side and we’re waiting for 4 weeks where he can, hopefully, have the right side embolized.

Our question is: does anyone know any way to minimize this from happening? The good/ bad is that his only symptom right now is pulsatile tinnitus, so our concern is that we won’t know when it happens, which puts him at greater risk of hemorrhage. Thankfully, thus far, he’s not had a bleed, but we’re concerned that our luck may run out. He’s 54 and his AV Fistula was diagnosed 1 year ago.

Any insight much appreciated.

God Bless you all,


Hi Joy,

I had a dural AVF with cortical venous drainage too. There aren't that many of us! Mine was right occipital lobe (not bilateral) but the vein was distended from the (years?) of arterial (read, high pressure) blood drainage. My doctor was Dr. Anand Germanwala at UNC Medical Center in Chapel Hill, NC, but he has since moved on to John's Hopkins. Anyway, he did all the diagnostics, etc., but the embos were actually done by Dr. Hortensia Alvarez at UNC. She's still there. Embos are pretty much all she does. I was under for about 6 hours. The radiation from the imaging they use during surgery caused my hair to fall out. Not all of it, but I shaved the rest. It has since grown back, but I like my profile pic as a reminder. Anyway, I was declared AVF-free after the one surgery. She never said how many embos were done. They don't really look at it that way for some reason. But she plugged that bad boy. I don't even have any more follow ups. I had one angio a couple months post-op, and everything looked good so they sent me home and said "have a nice life". I hope the same for your husband. I really do.

Good luck and Godspeed to your husband's healing,