Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Neurosurgery, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Br J Neurosurg. 2022 Aug;36(4):511-514. doi: 10.1080/02688697.2019.1639619. Epub 2019 Jul 9.
We report three patients who deteriorated after lumbar puncture (LP). Two patients were later found to have type іі (a + b) dural arteriovenous fistulas (DAVF) with high flow retrograde venous drainage on cerebral angiography. The third had a type II (a) DAVF. All patients recovered at least partially after DAVF treatment. In patients with signs and symptoms of increased intracranial pressure (ICP) but no evidence of focal mass lesion on cranial imaging, we suggest an evaluation for a DAVF before performing an LP.
我们报告了 3 例腰椎穿刺(LP)后病情恶化的患者。2 例患者后来被发现存在高流量逆行性静脉引流的 II 型(a+b)硬脑膜动静脉瘘(DAVF),脑血管造影检查发现存在 II 型(a)DAVF。所有患者在接受 DAVF 治疗后至少部分恢复。对于有颅内压(ICP)升高迹象和症状但颅成像无局灶性肿块病变证据的患者,我们建议在进行 LP 之前评估是否存在 DAVF。