以精神行为异常起病伴双侧丘脑肿胀进行性加重的硬脑膜动静脉瘘一例  

A case report of cerebral dural arteriovenous fistula with psychiatric and behavioral abnormalities and progressively worsening bilateral thalamic edema

作　　者：段小萱 唐娜[1] 陈健[2] 李京凯[3] 胡鹏[2] 吉训明[4] 段建钢[1] Duan Xiaoxuan;Tang Na;Chen Jian;Li Jingkai;Hu Peng;Ji Xunming;Duan Jiangang(Department of Emergency,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;不详)

机构地区：[1]首都医科大学宣武医院急诊科,北京100053 [2]首都医科大学宣武医院神经外科,北京100053 [3]首都医科大学宣武医院影像与核医学科,北京100053 [4]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国脑血管病杂志》2024年第9期616-625,共10页Chinese Journal of Cerebrovascular Diseases

摘　　要：以双侧丘脑肿胀进行性加重为主要表现的大脑大静脉区硬脑膜动静脉瘘(DAVF)的症状和影像学表现缺乏特异性,易与多种疾病相混淆。作者报道1例以精神行为异常起病,逐渐出现双侧丘脑病变,曾先后被误诊为“丘脑胶质瘤”“脑炎”“直窦血栓形成”,但其临床和影像学表现进行性加重,由外院转至我院,最终通过多模影像学检查确诊为大脑大静脉区DAVF。作者拟结合文献复习,分析大脑大静脉区DAVF的临床表现和影像学特点,以期提高临床医师对该病的认识。The clinical and imaging manifestations of the dural arteriovenous fistula(DAVF)located in the great cerebral vein area with progressive bilateral thalamic edema lack specificity and are easily confused with a variety of diseases.The authors reported a case presented with psychiatric and behavioral abnormalities,followed by bilateral thalamic lesions.Initially,the diagnosis was considered as a glioma of the thalamus,encephalitis and straight sinus thrombosis,but the clinical and imaging findings progressively worsened.Through multi-modal imaging examinations,a DAVF in the great cerebral vein territory was finally diagnosed.By reporting the case and reviewing the literature,this paper aimed to explore the clinical manifestations and imaging features of the disease to reduce the incidence of misdiagnosis.

关 键 词：中枢神经系统血管畸形 硬脑膜动静脉瘘 丘脑疾病 临床特征 影像学表现 

分 类 号：R743[医药卫生—神经病学与精神病学]