Kuiper L, Sánchez van Kammen M, Coert B A, Verbaan D, Emmer B J, Coutinho J M, van den Berg R
From the Departments of Neurology (L.K., M.S.v.K., J.M.C.).
Neurosurgery (B.A.C., D.V.).
AJNR Am J Neuroradiol. 2022 Dec;43(12):1722-1729. doi: 10.3174/ajnr.A7652. Epub 2022 Nov 17.
Recent reports suggest an association between dural AVFs and cerebral venous thrombosis. We aimed to investigate the specific temporal and anatomic association between the 2 conditions.
A consecutive cohort of adult patients with dural AVFs was seen at Amsterdam University Medical Centers (2007-2020). An experienced neuroradiologist re-evaluated the presence and imaging characteristics of dural AVFs and cerebral venous thrombosis on all available imaging. The temporal (previous/concurrent/subsequent) and anatomic (same/adjacent/unrelated venous sinus or vein) association between dural AVFs and cerebral venous thrombosis was determined.
Among 178 patients with dural AVFs, the mean age was 58.3 (SD, 13.2) years and 85 (48%) were women. Of 55 patients (31%) with cerebral venous thrombosis, 34 (62%) were women. Four patients (7%) had cerebral venous thrombosis before the development of a dural AVF, 33 (60%) had cerebral venous thrombosis at the time of dural AVF diagnosis (concurrent), and 18 (33%) developed cerebral venous thrombosis during follow-up after conservative treatment. The incidence rate of cerebral venous thrombosis after a dural AVF was 79 per 1000 person-years (95% CI, 50-124). In 45 (82%) patients with dural AVFs and cerebral venous thrombosis, the thrombosis was located in the same venous sinus as the dural AVF, whereas in 8 (15%) patients, thrombosis occurred in a venous sinus adjacent to the dural AVF.
One-third of patients with a dural AVF in this study were diagnosed with cerebral venous thrombosis. In almost two-thirds of patients, cerebral venous thrombosis was diagnosed prior to or concurrent with the dural AVF. In 97% of patients, there was an anatomic association between the dural AVF and cerebral venous thrombosis. These data support the hypothesis of a bidirectional association between the 2 diseases.
近期报告提示硬脑膜动静脉瘘（dural AVFs）与脑静脉血栓形成之间存在关联。我们旨在研究这两种情况之间具体的时间和解剖学关联。
对阿姆斯特丹大学医学中心连续收治的成年硬脑膜动静脉瘘患者队列（2007 - 2020年）进行研究。一位经验丰富的神经放射科医生对所有可用影像上硬脑膜动静脉瘘和脑静脉血栓形成的存在情况及影像特征进行重新评估。确定硬脑膜动静脉瘘与脑静脉血栓形成之间的时间（之前/同时/之后）和解剖学（相同/相邻/不相关的静脉窦或静脉）关联。
178例硬脑膜动静脉瘘患者中，平均年龄为58.3（标准差，13.2）岁，85例（48%）为女性。55例（31%）脑静脉血栓形成患者中，34例（62%）为女性。4例（7%）患者在硬脑膜动静脉瘘形成之前发生脑静脉血栓形成，33例（60%）在硬脑膜动静脉瘘诊断时（同时）发生脑静脉血栓形成，18例（33%）在保守治疗后的随访期间发生脑静脉血栓形成。硬脑膜动静脉瘘后发生脑静脉血栓形成的发病率为每1000人年79例（95%置信区间，50 - 124）。45例（82%）硬脑膜动静脉瘘合并脑静脉血栓形成的患者中，血栓位于与硬脑膜动静脉瘘相同的静脉窦，而8例（15%）患者的血栓发生在与硬脑膜动静脉瘘相邻的静脉窦。
本研究中三分之一的硬脑膜动静脉瘘患者被诊断为脑静脉血栓形成。近三分之二的患者在硬脑膜动静脉瘘之前或同时被诊断为脑静脉血栓形成。97%的患者中，硬脑膜动静脉瘘与脑静脉血栓形成之间存在解剖学关联。这些数据支持这两种疾病之间双向关联的假说。
