Su Xin, Song Zihao, Chen Yiguang, Huang Mingyue, Liu Huiwei, Zhang Chao, Pang Huishen, Sun Liyong, Ye Ming, Hong Tao, Ma Yongjie, Zhang Hongqi, Zhang Peng
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
China International Neuroscience Institute (CHINA-INI), Beijing, 100053, China.
Neurosurg Rev. 2025 Jan 10;48(1):35. doi: 10.1007/s10143-025-03203-y.
Dural arteriovenous fistulas (DAVFs) with deep venous drainage (DVD) (DAVFs-DVD) are characteristically associated with non-hemorrhagic neurological deficits, most notably cognitive impairment. Large studies have yet to thoroughly characterize these DAVFs. We conducted an analysis of the largest cohort of DAVFs-DVD to provide a comprehensive characterization of this specific subset.
This study was a retrospective cohort analysis of 207 patients with DAVFs-DVD who were hospitalized at a single medical center between 2001 and 2022. Logistic regression was employed to identify angiographic features specific to DAVFs associated with cognitive impairment. Additionally, post-treatment outcomes were evaluated.
DAVFs-DVDs can be classified into two categories: the Galenic group, where arterial feeders drain directly into the vein of Galen (VoG), and the non-Galenic group, where arterial feeders drain into other veins or venous sinuses and indirectly flow into the VoG. Cognitive impairment accounting for 15.9% of all clinical presentations. We found that the overall rate of complete occlusion was 86.6%, while the overall rate of complications was 16.4%. Moreover, patients with DAVFs-DVD presenting with cognitive impairment were more likely to have straight sinus stenosis or occlusion, as well as DAVFs located at the midline.
DAVFs-DVDs can be classified into two categories: the Galenic group and the non-Galenic group. Patients with DAVFs-DVD presenting with cognitive impairment were more likely to have straight sinus stenosis or occlusion, as well as DAVFs located at the midline. Venous hypertension of the deep venous system is a key angiographic feature of DAVFs associated with thalamic cognitive impairment.
伴有深部静脉引流（DVD）的硬脑膜动静脉瘘（DAVF）（DAVF-DVD）的特征是与非出血性神经功能缺损相关，最显著的是认知障碍。大型研究尚未对这些DAVF进行全面描述。我们对最大队列的DAVF-DVD进行了分析，以全面描述这一特定亚组。
本研究是一项回顾性队列分析，纳入了2001年至2022年期间在单一医疗中心住院的207例DAVF-DVD患者。采用逻辑回归来确定与认知障碍相关的DAVF的血管造影特征。此外，还评估了治疗后的结果。
DAVF-DVD可分为两类：盖伦组，动脉供血直接引流至大脑大静脉（VoG）；非盖伦组，动脉供血引流至其他静脉或静脉窦，间接流入VoG。认知障碍占所有临床表现的15.9%。我们发现完全闭塞的总体发生率为86.6%，而并发症的总体发生率为16.4%。此外，表现为认知障碍的DAVF-DVD患者更可能有直窦狭窄或闭塞，以及位于中线的DAVF。
DAVF-DVD可分为盖伦组和非盖伦组。表现为认知障碍的DAVF-DVD患者更可能有直窦狭窄或闭塞，以及位于中线的DAVF。深部静脉系统的静脉高压是与丘脑认知障碍相关的DAVF的关键血管造影特征。
