主要表现为认知功能障碍的硬脑膜动静脉瘘的临床特点(附1例报告)  

Clinical features of dural arteriovenous fistulas mainly manifested as cognitive impairment( report of 1 case)

作　　者：高海凤[1] 李永秋[1] 鲁琳[1] 尹春丽[1] 

机构地区：[1]唐山工人医院神经内科,063000

出　　处：《临床神经病学杂志》2014年第6期464-465,共2页Journal of Clinical Neurology

摘　　要：目的探讨主要表现为认知功能障碍的硬脑膜动静脉瘘(DAVF)的临床特点。方法回顾性分析1例主要表现为认知功能障碍的DAVF患者的临床资料。结果患者为中年女性,亚急性起病,表现为进行性加重的认知功能障碍,随后出现步态异常和尿失禁;发病1个多月后生活已不能自理。头颅MRI示两侧大脑、小脑半球表面多发异常迂曲、扩张的血管影,两侧大脑半球白质对称大片状T2WI、Flair高信号影。脑血管DSA示右侧颈外动脉动静脉瘘,左侧颈外动脉DAVF,右侧颈内静脉重度狭窄。经血管介入栓塞动静脉瘘及支架置入术治疗后,患者的病情显著改善。结论 DAVF的认知功能障碍起病较急,系颅内静脉高压引起的广泛脑白质病变所致,早期手术治疗的效果好。Objective To explore the clinical features of dural arteriovenous fistulas （DAVF） mainly manifested as cognitive impairment. Methods The clinical data of one case with DAVF was retrospectively analyzed. Results The patient was female, subacutely onset, manifested as progressive worsened dementia, followed by abnormal gait and urine incontinence. One month later, she was independent. The brain MRI showed multiple abnormal tortuous vessels located on the surface of bilateral hemispheres and cerebellum, and abnormal high signal lesions on T2WI and Flair imaging within bilateral hemispheric white matters. The cerebral DSA showed artero-venous fistula within right external carotid artery and dural fistula within left external carotid artery, also stenosis within right jugular vein. The symptoms were improved after intravascular intervention therapy. Conclusion DAVF can cause acute progressive dementia, which is due to diffuse white matter changes caused by venous hypertension, early operation gains good outcomes.

关 键 词：硬脑膜动静脉瘘 认知功能障碍 静脉高压性脑病 血管介入治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]