Berra Luigi Valentino, Armocida Daniele, D'Angelo Luca, Norcia Valerio Di, Santoro Antonio
A.U.O. "Policlinico Umberto I" - Neurosurgery Division - Sapienza University - Rome - Human Neurosciences Department - Via del Policlinico, 155 - 00161 - Roma, Italy.
Cereb Circ Cogn Behav. 2022 May 18;3:100146. doi: 10.1016/j.cccb.2022.100146. eCollection 2022.
Cerebrovascular malformations (CVMs) such as arteriovenous malformations (AVMs) or dural arteriovenous fistulas (DAVFs) represent a possible source of intracranial hemorrhage, but these malformations can also manifest with neurologic disorders secondary to ischemic penumbra from vascular steal. In the latter case, the clinical manifestations are less obvious and characteristic, and may include a varied clinical spectrum ranging from focal deficits to generalized malfunction of the brain parenchyma resulting in dementia. Dementias secondary to CVMs constitute a probably underestimated subpopulation of patients of great interest because they present with devastating but potentially reversible cognitive impairment. We examined the pertinent literature regarding the clinical manifestations of CVMs characterized by cognitive impairment and describe the distinctive clinical features. Our results confirm that cognitive impairment is one of the clinical manifestations of CVMs and is a frequently misrecognized and often late-diagnosed cause of reversible dementia.
脑血管畸形(CVMs),如动静脉畸形(AVMs)或硬脑膜动静脉瘘(DAVFs),是颅内出血的一个可能来源,但这些畸形也可表现为因盗血导致缺血半暗带继发的神经系统疾病。在后一种情况下,临床表现不那么明显和具有特征性,可能包括从局灶性缺损到脑实质广泛功能障碍导致痴呆的各种临床谱。CVMs继发的痴呆构成了一个可能被低估的、非常值得关注的患者亚群,因为他们表现出严重但可能可逆的认知障碍。我们查阅了有关以认知障碍为特征的CVMs临床表现的相关文献,并描述了其独特的临床特征。我们的结果证实,认知障碍是CVMs的临床表现之一,是一种经常被误诊且往往诊断较晚的可逆性痴呆病因。