Zhan Yu, Al-Nusaif Murad, Xu Chang, Li Jiahao, Zhao Li, Wang Feng, Dong Chunbo
Department of Neurology, The First Affiliated Hospital, Dalian Medical University, Dalian, China.
Liaoning Provincial Key Laboratories for Research on the Pathogenic Mechanisms of Neurological Diseases, First Affiliated Hospital, Dalian Medical University, Dalian, China.
Case Rep Neurol. 2022 Oct 31;14(3):404-412. doi: 10.1159/000527076. eCollection 2022 Sep-Dec.
Dementia is a gradual and irreversible loss of higher mental function, particularly memory. Dural arteriovenous fistulas (DAVFs) are one of the rare causes of a rapid decline in cognitive function, which can be curable. DAVFs are pathological shunts between the dural artery and the dural venous sinus, dural vein, or cortical vein. Here, we present a case that initially manifested nausea and dizziness and developed rapidly progressive dementia caused by DAVFs in the left transverse sinus-sigmoid sinus junction area and the sinus confluence area, combined with cerebral venous sinus thrombosis. Moreover, our case has multiple DAVFs that cause bilateral thalamic lesions and rapidly progressive dementia called thalamic dementia, which is infrequent and often misdiagnosed. His symptoms have improved after receiving endovascular embolization treatment. In addition to presenting our case, we conducted a systemic literature review to summarize how familiarity with the manifestation and early diagnosis of bilateral thalamic lesions caused by DAVFs can lead to earlier and more effective therapy.
痴呆是一种高级精神功能逐渐且不可逆的丧失，尤其是记忆力丧失。硬脑膜动静脉瘘（DAVF）是认知功能快速衰退的罕见原因之一，而这种衰退是可以治愈的。DAVF是硬脑膜动脉与硬脑膜静脉窦、硬脑膜静脉或皮层静脉之间的病理性分流。在此，我们报告一例最初表现为恶心和头晕，并因左横窦-乙状窦交界处及窦汇区的DAVF合并脑静脉窦血栓形成而迅速发展为进行性痴呆的病例。此外，我们的病例有多个DAVF，导致双侧丘脑病变并引发称为丘脑痴呆的快速进行性痴呆，这种情况并不常见且常被误诊。他在接受血管内栓塞治疗后症状有所改善。除了报告我们的病例外，我们还进行了系统的文献综述，以总结熟悉由DAVF引起的双侧丘脑病变的表现和早期诊断如何能带来更早且更有效的治疗。
