以耳鸣为主诉的硬脑膜动静脉瘘二例报告

Two Cases of the Chief Complaint of Tinnitus with Dural Arteriovenous Fistulas

目的提高对硬脑膜动静脉瘘(dural arteriovenous fistulas,DAVF)的认识,减少误诊。方法回顾分析2例以耳鸣为主诉的DAVF误诊病例的临床资料。结果 2例均以耳鸣伴头痛或视力下降为主诉,发病初期于外院误诊为病毒性脑膜炎、视神经炎,予相应治疗无效。入我院后经腰椎穿刺脑脊液检查及头颅MRI检查排除颅内感染及其他疾病,数字减影血管造影(DSA)检查确诊DAVF。结论临床上对不明原因的耳鸣伴头痛或视力下降等患者需警惕DAVF,应及时行DSA检查以确诊。

Objective To improve awareness of dural arteriovenous fistula（DAFA） and reduce misdiagnosis. Methods We conducted a retrospective study and analyzed the clinical data of two misdiagnosed patients with the chief complaint of tinnitus with DAFA.Results The 2 patients complained of tinnitus associated with headache or decreased vision.At an early stage,they were misdiagnosed as having viral meningitis,optic neuritis and given invalid therapy in other hospitals.We examined the cerebrospinal fluid by lumbar puncture and brain MRI to exclude intracranial infections and other diseases.They were diagnosed as having DAVF by digital subtraction angiography（DSA）. Conclusion Physicians should be cautious about DAVF in patients with clinically unexplained tinnitus associated with headaches or vision loss and DSA should be conducted to confirm diagnosis in time.