Dural arteriovenous fistula in a case of dementia with bithalamic MR lesions

Matsumura, Akihiro; Oda, Masayuki; Hozuki, Takayoshi; Imai, Tetsuaki; Shimohama, Shun

doi:10.1212/01.wnl.0000334403.46553.85

Cited by 18 publications

(13 citation statements)

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“…Venous congestion and ischemia of the thalamus occurred through venous hypertension followed by retrograde cerebral blood flow that caused thalamic dementia. As far as we know, a DAVF case with cognitive impairment and transient memory loss is uncommon [3678]. In our case, the patient had bilateral thalamic congestion due to a DAVF located in the posterior fossa and showed episodic memory loss with inattention and disorientation.…”

Section: Discussionmentioning

confidence: 68%

Dural Arteriovenous Fistula Manifested as Rapid Progressive Dementia Successfully Treated by Endovascular Embolization Only

Hwang

Baek

et al. 2017

Neurointervention

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A 43-year-old male presented with daytime sleepiness at work and indifferent behavior like never before. Two weeks prior to hospital admission, he had episodic memory loss with well preserved remote memory. Brain MRI showed a dural arteriovenous fistula (DAVF) in the right lateral transverse sinus with a bilateral thalamic venous infarction. Cerebral angiography confirmed a right transverse sigmoid dural arteriovenous fistula with a feeding artery of the right occipital artery and left posterior meningeal artery. The DAVF was completely eliminated through multiple endovascular interventions. Recently, endovascular treatment has become one of the main therapeutic options to obliterate a fistulous site, which has led to a rapid diagnostic approach and management of DAVFs with high curative rates. We report a rare case of posterior fossa located at a dural arteriovenous fistula that caused rapid progressive dementia and was successfully eliminated through only endovascular treatment.

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Section: Discussionmentioning

confidence: 68%

Dural Arteriovenous Fistula Manifested as Rapid Progressive Dementia Successfully Treated by Endovascular Embolization Only

Hwang

Baek

et al. 2017

Neurointervention

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“…These symptoms are accompanied by a more focused profile of hyperintensities on FLAIR and T2-weighted imaging primarily involving the bilateral thalami. [21][22][23]32,34,48,49,53,62,65,73,[76][77][78]86,88 dural avF-induced thalamic dementia: presentation, imaging, treatment, and outcome Dural AVF -induced syndrome occurs almost exclusively in men in their 5th-7th decades of life, typically without prior history of neurological trauma. The most common symptoms of this syndrome are deficits in attention, memory, executive functioning, and disorientation.…”

Section: Discussionmentioning

confidence: 99%

“…All were individual case reports, and several lacked adequate clinical, radiographic, and/or treatment specifics to permit detailed assessment as to manner of presentation, underlying hemodynamic pathophysiology, and long-term outcome. 18,[21][22][23]32,49,53,62,65,73,[76][77][78]86,88 None provided a comprehensive literature review.Here, we report 4 cases of dAVF with CVD involving the vein of Galen that presented with a rapidly progressive thalamic dementia syndrome. The specific pattern of presentation, diagnostic imaging findings, method of treatment, and long-term patient outcome as well as a critical review of the literature are provided.…”

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confidence: 99%

Dural arteriovenous fistula-induced thalamic dementia: report of 4 cases

Holekamp

Mollman

Murphy

et al. 2016

JNS

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Nonhemorrhagic neurological deficits are underrecognized symptoms of intracranial dural arteriovenous fistulas (dAVFs) having cortical venous drainage. These symptoms are the consequence of cortical venous hypertension and portend a clinical course with increased risk of neurological morbidity and mortality. One rarely documented and easily misinterpreted type of nonhemorrhagic neurological deficit is progressive dementia, which can result from venous hypertension in the cortex or in bilateral thalami. The latter, which is due to dAVF drainage into the deep venous system, is the less common of these 2 dementia syndromes. Herein, the authors report 4 cases of dAVF with venous drainage into the vein of Galen causing bithalamic edema and rapidly progressive dementia. Two patients were treated successfully with endovascular embolization, and the other 2 patients were treated successfully with endovascular embolization followed by surgery. The radiographic abnormalities and presenting symptoms rapidly resolved after dAVF obliteration in all 4 cases. Detailed descriptions of these 4 cases are presented along with a critical review of 15 previously reported cases. In our analysis of these 19 published cases, the following were emphasized: 1) the clinical and radiographic differences between dAVF-induced thalamic versus cortical dementia syndromes; 2) the differential diagnosis and necessary radiographic workup for patients presenting with a rapidly progressive thalamic dementia syndrome; 3) the frequency at which delays in diagnosis occurred and potentially dangerous and avoidable diagnostic procedures were used; and 4) the rapidity and completeness of symptom resolution following dAVF treatment.http://thejns.org/doi/abs/10.3171/2015.5.JNS15473Key words dural arteriovenous fistula; cortical venous hypertension; thalamic edema; nonhemorrhagic neurological deficit; thalamic dementia; vascular disorders ©AANS, 2016 davF-induced thalamic dementiaBorden-Shucart classification system-based not only on angiographic appearance but also mode of presentationto permit more accurate risk stratification and assist with clinical decision making for the type and timing of dAVF treatment (Table 1). 68,91One relatively underappreciated type of NHND is progressive dementia resulting from dAVF-induced cortical venous hypertension, though correct diagnosis and treatment is increasing, thanks to improved imaging techniques.18,79 Dural AVF-induced progressive dementia can be differentiated as either cortical or thalamic in origin-2 categories that have relatively distinct patterns of clinical symptomatology 18,54,62,80,85 and highly specific venous outflow patterns.18,80 Of the two, dAVFinduced thalamic dementia is less frequent, with only 15 published cases reported in the literature to date. All were individual case reports, and several lacked adequate clinical, radiographic, and/or treatment specifics to permit detailed assessment as to manner of presentation, underlying hemodynamic pathophysiology, and long-term outcome. 18,[21][22][23]...

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“…Though deep venous thrombosis is the most important reason for venous congestion in the thalami, structural lesions like dural arteriovenous fistula (dural AVF) have also been reported to play a role in the literature. [3][4][5][6][7][8] Pial arteriovenous fistula (pial AVF) has been recently recognized as a distinct intracranial vascular pathological entity that has characteristics different from dural AVF or routine arteriovenous malformations (AVMs). 9,10 Such lesions consist of one or more arterial connections to a single venous channel without any intervening nidus of vessels or capillaries.…”

Section: Introductionmentioning

confidence: 99%