无症状硬脑膜动静脉瘘进展至丘脑痴呆:1例病例报告及文献复习

Asymptomatic dural arteriovenous fistula progressing to thalamic dementia:A case report and literature review

目的总结硬脑膜动静脉瘘(duralarteriovenousfistula,DAVF)丘脑性痴呆的诊治经验。方法回顾分析1例经脑血管造影诊断为BordenⅢ型或CognardⅣ型DAVF41岁女性病例资料,尤其是病程中随访MRI。结果该患者临床表现为快速进展性认知障碍,头颅MRI提示双侧丘脑异常信号。在接受经动脉栓塞治疗后,瘘口完全栓塞,后续认知功能和丘脑异常得到明显改善。术后随访半年,患者恢复日常工作。结论从无症状进展至痴呆的连续头颅MRI检查,提示大脑大静脉持续扩张,可为阐明DAVF病程提供新临床依据。

Objective To summarize the experience in the diagnosis and treatment of thalamic dementia caused by dural arteriovenous fistula(DAVF).Methods A retrospective analysis was performed on the data of a 41-year-old female case diagnosed with BordenⅢor CognardⅣDAVF through cerebral angiography,especially the MRI follow-up during the disease course.Results The clinical manifestations were rapid progressive cognitive impairment,with cranial MRI indicating abnormal signals in the bilateral thalamus.After receiving transarterial embolization treatment,the fistula was completely embolized,and subsequent cognitive function and thalamic abnormalities were significantly improved.After half a year of postoperative follow-up,the patient resumed daily work.Conclusion Continuous cranial MRI examination from asymptomatic progression to dementia,suggests continuous dilation of the great cerebral vein,providing new clinical evidence for elucidating the course of DAVF.