容易漏诊的硬脑膜动静脉瘘临床特点分析  

Clinical features of du ral arteriovenous fistula with easily missed diagnosis

作　　者：叶强[1] 郑荣远[1] 邵蓓[1] 周成业[1] 钟鸣[2] 谭显西[2] 程建华[1] 叶祖森[1] 杨学志[1] 王虹[1] 李则群[2] 郑匡[2] 

机构地区：[1]温州医科大学附属第一医院神经内科,温州325000 [2]温州医科大学附属第一医院神经外科,温州325000

出　　处：《中华神经创伤外科电子杂志》2015年第5期17-20,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的提高对容易漏诊的硬脑膜动静脉瘘(DAVF)的诊断水平。方法回顾性总结2008年1月至2014年5月在温州医科大学附属第一医院神经内科收治的6例DAVF患者,临床表现不典型、容易漏诊的DAVF的临床资料,结合既往文献,进行分析。结果 6例患者主要临床表现:1例表现为长期头痛伴脑鸣,1例表现为双下肢乏力伴头痛,1例表现为三叉神经痛,2例表现为视力下降,1例长期头痛。2例患者头颅MRV提示血栓形成,1例患者MR平扫提示左侧桥小脑角异常血管团形成。6例病例诊断初期均忽略了DAVF。结论 DAVF临床上相对少见,临床表现多变,缺乏特异性,容易导致漏诊,临床医师在临床工作中应增加对该病的认识。Objective To improve the diagnostic capability of dural arteriovenous fistula （DAVF） which easily leads to missed diagnosis. Methods The clinical information of 6 cases of DAVF from January 2008 to May 2014 in our hospital was summarized retrospectively, and analyzed with a literature review. Results The main clinical manifestations of 6 cases were： 1 cases presenting with prolonged headaches and tinnitus cerebri; 1 case presenting with weakness of lower limbs and headache; 1 case presenting with trigeminal neuralgia; 2 case presenting with impaired vision; i case presenting with prolonged headaches. MRV of 2 case showed cerebral venous sinus thrombosis, MR scan of 1 case revealed abnormal vascular mass of cerebellopontine. Early diagnosis of 6 cases are all omitted from DAVF. Conclusions Relative rarity of DAVF and the variousness of its clinical manifestations may lead to missed diagnosis; The clinicians should increase awareness of the disease in clinical work.

关 键 词：硬脑膜动静脉瘘 漏诊 头痛 

分 类 号：R743[医药卫生—神经病学与精神病学]