How I do it: Surgical interruption of high-flow dural arteriovenous fistulas at the foramen magnum region

Abstract Background Dural arteriovenous fistulas (dAVFs) in the foramen magnum region (FMR) are rare entity of dAVFs. There is no established treatment for FMR-dAVFs owing to their rarity and anatomical complexity. Herein, we report cases of high-flow dAVFs located at the posteromedial part of the FMR that were successfully treated by surgical interruption. Methods We demonstrated the surgical procedures for the interruption of high-flow FMR-dAVF with representative images and videos. In both cases, endovascular transarterial embolization was performed prior to surgical interruption. Conclusion As this type of FMR-dAVF has high-risk clinical features, curative surgical treatment is highly desirable.