Tanaka K, Morooka Y, Nakagawa Y, Shimizu S
Department of Neurosurgery, Saiseikai Matsusaka General Hospital, Mie, Japan.
Surg Neurol. 1999 May;51(5):489-93; discussion 493-4. doi: 10.1016/s0090-3019(98)00020-2.
Although dementia is one of the curable manifestations of a dural arteriovenous malformation (AVM), the pathophysiology remains unclear.
We describe an elderly patient who had an AVM in the tentorium and manifested signs of dementia from ischemia, predominantly in the bilateral thalami. Intravascular embolization of the dural AVM resulted in amelioration of signs of dementia, and this improvement was consistent with that of neuroradiological and hemodynamic conditions in the thalami.
The coincidental improvement of CBF in the thalami and signs of dementia after embolization of the AV shunt supports the concept of primary participation of the thalami in the pathophysiology of dementia of vascular origin in our patient.
尽管痴呆是硬脑膜动静脉畸形（AVM）的可治愈表现之一，但其病理生理学仍不清楚。
我们描述了一名老年患者，其小脑幕存在AVM，并因缺血出现痴呆症状，主要累及双侧丘脑。硬脑膜AVM的血管内栓塞术使痴呆症状得到改善，且这种改善与丘脑的神经放射学和血流动力学状况一致。
AV分流栓塞术后丘脑局部脑血流量（CBF）和痴呆症状的同步改善支持了丘脑在我们患者血管性痴呆病理生理学中起主要作用的观点。
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