Cervical Dural Arteriovenous Fistulae Manifesting as Subarachnoid Hemorrhage: Report of Two Cases and Literature Review

craniocervical junction are rare but clinically important. DAVFs can be associated with subarachnoid hemorrhage (SAH), a feature distinguishing them from DAVFs in the thoracolumbar region. These lesions are often overlooked at cerebral angiography performed to assess SAH and account for a small proportion of angiographically negative SAHs. After managing two cases of cervical spinal DAVF manifesting as SAH, we analyzed all cases in the literature to identify features associated with bleeding at presenta-tion. Spinal dural arteriovenous fistulas (DAVFs) are small arteriovenous fistulas situated within the dura layers. They most commonly occur at the dorsal tho-racolumbar junction in middle-aged men (1–3) and rarely bleed (1). Presenting symptoms and signs are progressive myelopathy with spastic paraparesis, sen-sory disturbances, and bowel and bladder dysfunction (4). In a number of patients, DAVFs are situated in the cervical spine and at the craniocervical junction. These lesions differ from their counterparts in the thoracolum-bar region and have a wider mode of presentation, including subarachnoid hemorrhage (SAH) (4–14), ra