Hwang Heewon, La Yun Kyung, Baek Min Seok, Baik Kyoungwon, Suh Sang Hyun, Kim Won-Joo
Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Neurointervention. 2017 Mar;12(1):50-53. doi: 10.5469/neuroint.2017.12.1.50. Epub 2017 Mar 6.
A 43-year-old male presented with daytime sleepiness at work and indifferent behavior like never before. Two weeks prior to hospital admission, he had episodic memory loss with well preserved remote memory. Brain MRI showed a dural arteriovenous fistula (DAVF) in the right lateral transverse sinus with a bilateral thalamic venous infarction. Cerebral angiography confirmed a right transverse sigmoid dural arteriovenous fistula with a feeding artery of the right occipital artery and left posterior meningeal artery. The DAVF was completely eliminated through multiple endovascular interventions. Recently, endovascular treatment has become one of the main therapeutic options to obliterate a fistulous site, which has led to a rapid diagnostic approach and management of DAVFs with high curative rates. We report a rare case of posterior fossa located at a dural arteriovenous fistula that caused rapid progressive dementia and was successfully eliminated through only endovascular treatment.
一名43岁男性因工作时白天嗜睡及出现前所未有的淡漠行为前来就诊。入院前两周,他出现发作性记忆丧失,远期记忆保存完好。脑部磁共振成像(MRI)显示右侧外侧横窦硬脑膜动静脉瘘(DAVF)伴双侧丘脑静脉梗死。脑血管造影证实为右侧横窦乙状窦硬脑膜动静脉瘘,供血动脉为右侧枕动脉和左侧脑膜后动脉。通过多次血管内介入治疗,该DAVF被完全消除。近年来,血管内治疗已成为闭塞瘘口的主要治疗选择之一,这使得对DAVF能够快速进行诊断并治疗,治愈率很高。我们报告了一例罕见的位于后颅窝的硬脑膜动静脉瘘病例,该病例导致快速进展性痴呆,仅通过血管内治疗就成功消除了瘘口。