Dural arteriovenous malformation manifesting as dementia due to ischemia in bilateral thalami. a case report.

Tanaka, Kimito; Morooka, Yoshito; Nakagawa, Yutaka; Shimizu, Shigetoshi

doi:10.1016/s0090-3019(98)00020-2

Cited by 29 publications

(25 citation statements)

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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%

“…Five of the 19 patients underwent cerebral emission imaging (3 SPECT, 1 Xenon CT, and 1 PET), and 1 received MR spectroscopy. 32,73,[76][77][78] Bithalamic hypoperfusion (4 of 4; 100%) and bithalamic congestion (2 of 2; 100%) were found each time these investigations were performed. PET results demonstrated bithalamic increase in fluorodeoxyglucose uptake in the single patient who underwent (Case 3).…”

Section: Neuroimagingmentioning

confidence: 99%

“…Strong gadolinium enhancement is most consistent with a high-grade neoplasm; 26,27,58 however, other conditions including dAVFs can also have some degree of gadolinium enhancement. 62,76,77 Therefore, vigilance is required when considering the diagnosis of neoplasm, and additional diagnostic tests are often indicated prior to proceeding with stereotactic brain biopsy. The distribution of T2/FLAIR signal hyperintensities may also offer clues to the diagnosis.…”

Section: Thalamic Dementia Syndrome: Differential Diagnosis and Workupmentioning

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%

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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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Section: Discussionmentioning

confidence: 99%

Section: Neuroimagingmentioning

confidence: 99%

Section: Thalamic Dementia Syndrome: Differential Diagnosis and Workupmentioning

confidence: 99%

mentioning

confidence: 99%

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

Holekamp

Mollman

Murphy

et al. 2016

JNS

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“…Effective treatment of DAVMs, with obliteration of all AV shunting, has been shown to result in reversal of neurological deficits [148,[165][166][167][168][169][170][171][172], including visual loss [173,174]. However, complications can occur from all modalities of management (including observation alone), and progression of venous thrombosis and venous hypertension resulting in death can occur despite multiple attempts at intervention [175,176].…”

Section: Prognosismentioning

confidence: 99%