Neurology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Radiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
BMJ Case Rep. 2020 Jul 9;13(7):e234907. doi: 10.1136/bcr-2020-234907.
Dural arteriovenous fistulas are relatively rare. Some cases are difficult to diagnose, leading to unnecessary investigations, treatments and delays, particularly if the presentation is atypical. We report a case of a man who presented with progressive dementia and bulbar symptoms, both under-recognised non-haemorrhagic neurological deficits, caused by cortical venous hypertension. Brain imaging showed unusual bilateral thalamic, tectal plate and midbrain oedema. The patient was investigated and treated for alternative aetiologies, before being correctly diagnosed and managed using angiographic embolisation. His clinical and radiological signs improved significantly following treatment, reducing his risk of neurological morbidity and mortality.
硬脑膜动静脉瘘较为罕见。部分病例难以诊断，导致不必要的检查、治疗和延误，尤其是临床表现不典型时。我们报告了一例表现为进行性痴呆和球部症状的男性病例，这些都是皮质静脉高压引起的未被充分认识的非出血性神经功能缺损。脑部影像学显示双侧丘脑、顶盖和中脑异常水肿。该患者因其他病因接受了检查和治疗，在被正确诊断并采用血管造影栓塞治疗后，病情得到了显著改善。治疗后他的临床和影像学症状明显改善，降低了他的神经功能障碍和死亡风险。
