Background: A cerebral arteriovenous fistula is a rare neurovascular abnormality. It is very scarce when presenting with other cerebral arteriovenous malformations after embolization.
Method: We reported a case primarily presenting with cerebral arteriovenous fistula. When the fistula was embolized completely, de novo multiple dural arteriovenous fistulas and a small arteriovenous malformation occurred due to the hemodynamic change after the embolization. Embolization of parts of the fistulas for the second time led to an untreatable malformation which became curable. At the third time, the remaining fistula was cured.
Results: The mechanism of the dural arteriovenous fistula and treatment strategy were discussed.
Conclusion: Venous hypertension is the main factor causing a dural arteriovenous fistula. Embolization of the fistulas step by step is recommended.