Valentino William L, Stout Charles, Bui Duy
Riverside Community Hospital, Department of Radiology, 4445 Magnolia Ave, Riverside, CA, 92501, USA.
HCA Healthcare, Nashville, TN, USA.
Radiol Case Rep. 2022 Jun 4;17(8):2790-2794. doi: 10.1016/j.radcr.2022.05.009. eCollection 2022 Aug.
Dural arteriovenous fistulas are rare intracranial vascular malformations with a propensity for hemorrhage. The Cognard classification system is the most widespread classification system wherein type IIB through V must be promptly treated to avoid the risk of hemorrhage. The case presented herein reports a 71-year-old male presenting with vague non-hemorrhagic neurologic deficits found to have a Cognard type III dural arteriovenous fistula with multiple arterial feeders. Although quite obvious in retrospect, a DAVF can be missed even by an astute radiologist. This should be considered a "never miss" diagnosis as it carries a risk of intracranial hemorrhage and death.
硬脑膜动静脉瘘是一种罕见的颅内血管畸形，有出血倾向。科尼亚尔分类系统是最广泛应用的分类系统，其中IIB型至V型必须立即治疗以避免出血风险。本文报告的病例为一名71岁男性，表现为不明确的非出血性神经功能缺损，经检查发现患有伴有多个供血动脉的科尼亚尔III型硬脑膜动静脉瘘。尽管事后看来非常明显，但即使是经验丰富的放射科医生也可能漏诊硬脑膜动静脉瘘。由于其存在颅内出血和死亡风险，应将其视为“绝不能漏诊”的疾病。
