Martinez-Burbano Braulio, Correa Diaz Edgar Patricio, Jácome Sánchez Carolina
Carlos Andrade Marin Hospital, Quito, Ecuador.
J Investig Med High Impact Case Rep. 2016 Dec 1;4(4):2324709616683722. doi: 10.1177/2324709616683722. eCollection 2016 Oct-Dec.
Intracranial dural arteriovenous fistulas (DAVFs) are abnormal communications between arteries and veins or dural venous sinuses, which sit between the sheets of the dura. They represent 10% to 15% of intracranial vascular malformations. Clinical manifestations and prognosis depend on the pattern of venous drainage and location. The clinical presentation of DAVF may be mistaken for vascular or nonvascular brain pathologies. For that reason, within the differential diagnosis come a wide range of conditions, such as secondary headaches, encephalopathies, dementias including those with rapid progression, neurodegenerative diseases, inflammatory processes, or tumors typically at the orbital level or in the cavernous sinus. Diagnosis requires a high degree of suspicion because of the multiplicity of symptoms and presentations, making this pathology an entity that provides a major challenge for clinicians, yet early and multidisciplinary treatment of high-grade fistulas improve the possibility of avoiding poor or unfavorable outcomes for the patient.
颅内硬脑膜动静脉瘘（DAVF）是动脉与静脉或硬脑膜静脉窦之间的异常交通，位于硬脑膜层之间。它们占颅内血管畸形的10%至15%。临床表现和预后取决于静脉引流模式和位置。DAVF的临床表现可能被误诊为血管性或非血管性脑部病变。因此，在鉴别诊断中包括多种情况，如继发性头痛、脑病、包括快速进展型在内的痴呆、神经退行性疾病、炎症过程或通常位于眼眶水平或海绵窦的肿瘤。由于症状和表现的多样性，诊断需要高度怀疑，这使得这种病理成为临床医生面临的重大挑战，然而，对高级别瘘进行早期多学科治疗可提高避免患者出现不良或不利结局的可能性。
