小脑幕硬脑膜动静脉瘘临床及影像学特点

Clinical and imaging features of eleven patients with intracranial tentorial dural arteriovenous fistulas

目的总结小脑幕硬脑膜动静脉瘘(DAVF)的临床表现及影像学特点。方法回顾分析11例小脑幕DAVF病例的临床及影像学资料。结果本组男7例,女4例,平均年龄56.2岁;急性起病6例,亚急性起病2例,慢性起病3例;临床主要表现头痛、头晕、恶心、呕吐、眼震、共济失调等;头颅CT联合MRI检查可提示颅内出血性病变、非出血性病变、血管流空或异常血管影;DSA检查可清楚显示小脑幕DAVF瘘口、供血动脉和引流静脉。结论小脑幕DAVF临床表现多变,一些MRI特征性改变可提供小脑幕DAVF诊断线索,但确诊依赖DSA检查。

Objective To summarize the clinical and imaging characteristics of tentorial dural arteriove- nous fistulas （DAVE）. Methods The clinical and imaging data of eleven patients with tentorial DAVF were reviewed retrospectively. Results Seven males and four females were enrolled and the mean age of them was 56. 2 years. Six cases presented with acute onset, two with subacute onset and three with chronic onset. Com- mon manifestations included headache, vertigo, nausea, vomiting, nystagmus, ataxia and so on . Cranial CT and MRI examinations could present with abnormal changes such as hemorrhage, nonhemorrhagic lesions, vas- cular flow void signal or abnormal vascular image. DSA examination could chearly show DAVFs in tentorium of cerebellum, feeding arteries and draining veins. Conclusions Tentorial DAVF may cause different clinical man- ifestations. Some characteristic changes of brain MRI may provide diagnostic clues of tentorial DAVF. But its definite diagnosis depends on DSA examination.