Department of Neurology, Dongguk University Ilsan Hospital and Dongguk University-Seoul Graduate School of Medicine, Goyang, Korea.
J Neurosurg. 2011 Mar;114(3):830-3. doi: 10.3171/2010.5.JNS10128. Epub 2010 Jun 11.
Intracranial dural arteriovenous fistula (DAVF) is rare and potentially life-threatening disease often presenting as vascular myelopathy. The early and proper diagnosis is challenging because the clinical manifestations are related to the distribution of the draining vein, not the fistula site, and imaging findings are similar to demyelinating disease of the spinal cord. The authors present the case of a 45-year-old man who developed acute progressive quadriplegia and respiratory difficulty with an enhancing, longitudinally extensive cervical cord lesion. These symptoms were highly suspicious for transverse myelitis but were caused by an intracranial DAVF. Intracranial DAVF with venous reflux to the brainstem and spinal cord is a rare but important differential diagnosis of progressive worsening myelopathy that is treatment resistant and gives the diagnostic impression of transverse myelitis.
颅内硬脑膜动静脉瘘（DAVF）是一种罕见且潜在危及生命的疾病，常表现为血管性脊髓病。由于临床表现与引流静脉的分布有关，而与瘘口部位无关，且影像学表现类似于脊髓脱髓鞘疾病，因此早期和正确的诊断具有挑战性。作者报告了一例 45 岁男性病例，该患者出现急性进行性四肢瘫痪和呼吸困难，伴有增强的、纵向广泛的颈髓病变。这些症状高度怀疑为横贯性脊髓炎，但实际上是由颅内 DAVF 引起的。颅内 DAVF 伴静脉反流至脑干和脊髓是进行性加重脊髓病的一种罕见但重要的鉴别诊断，这种脊髓病对治疗有抗性，并给出了横贯性脊髓炎的诊断印象。
