Panagiotopoulos V, Kastrup O, Wanke I
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, D-45122, Essen, Germany.
J Clin Neurosci. 2009 Feb;16(2):317-20. doi: 10.1016/j.jocn.2008.02.022. Epub 2008 Dec 16.
Tentorial dural arteriovenous fistulas (tDAVF) clinically present usually with subarachnoid and/or intraparenchymal hemorrhage. Reported rates range from 58% to 92% and neurological deficits occur in 79% to 92% of patients. This is due to venous congestion resulting from retrograde leptomeningeal venous drainage, which rarely, can be clinically silent. A 69-year-old woman presented with vertigo, double vision and gait instability. Cerebral digital subtraction angiography revealed a tDAVF with retrograde cerebellar venous drainage directed through the vein of Galen into the straight sinus. MRI showed extensive cerebellar edema due to venous congestion. Clinical manifestations of cerebellar and brainstem dysfunction resolved completely after transarterial embolization with N-butylcyanoacrylate.
天幕硬脑膜动静脉瘘（tDAVF）临床上通常表现为蛛网膜下腔和/或脑实质内出血。报告的发生率在58%至92%之间，79%至92%的患者会出现神经功能缺损。这是由于软脑膜静脉逆行引流导致静脉充血，极少数情况下，临床上可能没有症状。一名69岁女性出现眩晕、复视和步态不稳。脑数字减影血管造影显示一个tDAVF，有通过大脑大静脉逆行至直窦的小脑静脉引流。MRI显示由于静脉充血导致广泛的小脑水肿。经动脉用N-丁基氰基丙烯酸酯栓塞后，小脑和脑干功能障碍的临床表现完全消失。
