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October 2, 2025Open Access

Endoscope-assisted supraorbital eyebrow approach for the treatment of ethmoidal dural arteriovenous fistula

Key Points

Successful treatment of a 65-year-old patient with ethmoidal DAVF was achieved using an endoscope-assisted technique.
Ethmoidal DAVFs account for 10%-15% of intracranial DAVFs, highlighting the need for effective treatment methods.
Surgical disconnection remains the gold standard, but reported endovascular treatments show promise for patients.
This approach emphasizes the importance of understanding anatomical and radiographical considerations during the procedure.

Abstract

Ethmoidal DAVFs represent 10%–15% of all intracranial DAVFs. They are generally associated with a higher bleeding risk due to more malignant drainage characteristics and, regardless of a patient’s symptoms, their treatment is highly recommended. Surgical disconnection has long been regarded as the gold-standard treatment for ethmoidal DAVFs, but several reports of successful endovascular treatments have been made. The authors present a case of a 65-year-old patient with an occasional finding of ethmoidal DAVF treated through an endoscope-assisted supraorbital eyebrow approach. In this video, they explain the radiographical, anatomical, and surgical considerations and demonstrate the surgical technique. The video can be found here: https://stream.cadmore.media/r10.3171/2025.7.FOCVID2580

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