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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Dural arteriovenous fistula disguised as cerebral venous sinus thrombosis

Abstract: Dural arteriovenous fistulas (DAVFs) are direct communications between the intracranial arterial and venous systems without an intervening nidus. Clinicians sometimes fail to give a correct diagnosis of DAVF. Given the similarity of their clinical and magnetic resonance imaging (MRI) manifestations, diagnostic confusion may arise between DAVF and cerebral venous sinus thrombosis (CVST) (Simon et al., 2009). The clinical management of DAVFs differs from that of CVST (Ma et al., 2015; Yang et al., 2015). Anticoagulation therapy is restricted in some cases of DAVFs, especially when they are associated with retrograde venous flow, due to the increased risk of hemorrhage. Here we present a case of a DAVF patient who had been initially misdiagnosed as CVST. We summarize the reasons for misdiagnosis and give some recommendations to address this problem.

Key words: Dural arteriovenous fistula; Cerebral sinus thrombosis; Susceptibility-weighted MRI; Digital subtraction angiography

Chinese Summary  <20> 类似脑静脉窦血栓的硬脑膜动静脉瘘病例分析

概要:静脉窦血栓与硬脑膜动静脉瘘在临床症状及影像学表现上相似,易混淆诊断,但二者治疗方案不同,区别二者具有重要的临床意义。本文详细分析了一例类似静脉窦血栓的硬脑膜动静脉瘘病例的临床症状、影像学表现及诊断和治疗(开颅硬脑膜动静脉瘘栓塞术),并结合文献回顾,总结二者诊治差别。在发病机制方面硬脑膜动静脉瘘与静脉窦血栓之间可能互为因果作用,容易造成二者混淆。基于非数字减影血管造影检查诊断为"脑静脉窦血栓"的病例,应进一步完善全脑动脉造影检查明确是否存在硬脑膜动静脉瘘,特别是在颅脑磁敏感成像上提示存在静脉窦高信号影时更应该警惕。

关键词组:硬脑膜动静脉瘘;脑静脉窦血栓;颅脑磁敏感成像;全脑动脉造影


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DOI:

10.1631/jzus.B1600499

CLC number:

R743.3

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On-line Access:

2017-08-08

Received:

2016-11-03

Revision Accepted:

2017-04-14

Crosschecked:

2017-07-19

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