Departments of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
BMC Neurol. 2023 Mar 30;23(1):131. doi: 10.1186/s12883-023-03141-6.
The Dural Arteriovenous Fistulas (DAVFs) secondary to cerebral venous sinus thrombosis (CVST) are rather rare. The aim of present study is to investigate the clinical and radiological features, and treatment outcome of DAVFS in patients following CVST.
Data about demographic information, clinical presentations, radiological findings, as well as treatment and outcome of DAVFs sequence to CVST were collected to analysis from January 2013 to September 2020 in this retrospective study.
Fifteen patients with DAVFs after CVST were included in the study. The median age was 41 years (range17-76 years). Ten patients (66.67%) were male and 6 patients (33.33%) were female. The median duration of presenting CVST was 182 days (Range 20-365). Mean time from diagnosis of CVST to confirmation of DAVFs was 97 days (range 36-370 days). The most common manifestations of DAVFs following CVST were headache and visual disturbance seen in 7 patients respectively. Five patients had pulsatile tinnitus (%) and 2 had nausea/vomiting. The DAVFs are most frequently located at the transverse/sigmoid sinus (7/15, 46.67%), followed by the superior sagittal the sinus and confluence sinus (6/15, 40.00%) respectively. Angiography of DAVFs revealed Board type I in seven (46.7%) patients, Board type II and III in 4(26.7%) patients, respectively. The Cognard I was noted in seven (46.7%), Cognard IIa and IV in 3 patients, IIb and III in one patient, respectively. The main feeding arteries of DAVFs most commonly originate from the branches of the external carotid artery in 6 (40.0%) patients. The other DAVFs are conjointly supplied by multiple feeders from internal and external carotid artery and vertebral arteries. Fourteen (93.33%) patients were treated with endovascular embolization and none of the patients had permanent deficits during follow-up.
Intracranial DAVFs following CVST are rare presentations. Most patients have a good outcome after timely interventional therapy. Continued observation and follow-up of (DSA) are important to find DAVFs secondary to CVST.
脑静脉窦血栓形成（CVST）后出现的硬脑膜动静脉瘘（DAVF）较为罕见。本研究旨在探讨 CVST 后 DAVF 的临床和影像学特征及治疗转归。
回顾性分析 2013 年 1 月至 2020 年 9 月期间，经头颅 MRI 或 MRV 检查诊断为 CVST 后出现 DAVF 的患者的临床资料，包括患者的人口统计学信息、临床表现、影像学检查结果以及治疗和预后。
本研究共纳入 15 例 CVST 后出现 DAVF 的患者，其中男 10 例（66.67%），女 6 例（33.33%），中位年龄为 41 岁（17-76 岁）。15 例患者中，10 例（66.67%）表现为头痛，7 例（46.67%）表现为视物模糊。5 例（33.33%）患者出现搏动性耳鸣，2 例（13.33%）出现恶心/呕吐。CVST 至确诊 DAVF 的中位时间为 97 天（36-370 天）。DSA 显示，DAVF 最常位于横窦/乙状窦（7/15，46.67%），其次为上矢状窦和窦汇（6/15，40.00%）。DAVF 的分型：Board Ⅰ型 7 例（46.7%），Board Ⅱ型和Ⅲ型各 4 例（26.7%），CognardⅠ型 7 例（46.7%），CognardⅡa 型和Ⅳ型各 3 例，Ⅱb 型和Ⅲ型各 1 例。供血动脉：颈外动脉分支 6 例（40.0%），颈内动脉和椎动脉 4 例（26.7%），颈内动脉和颈外动脉 2 例（13.3%），颈内动脉和椎动脉 2 例（13.3%），颈内动脉、颈外动脉和椎动脉 1 例（6.7%）。14 例行血管内栓塞治疗，随访期间均未遗留永久性神经功能缺损。
CVST 后出现的颅内 DAVF 较为罕见，及时进行介入治疗可获得良好的预后。持续观察和随访（DSA）对发现 CVST 后 DAVF 具有重要意义。
