Dural Arteriovenous Fistulas Presenting as Symmetric Lesions in the Internal Capsule on Imaging Studies: A Case Report and Literature Review.

IF 1.1 4区医学 Q4 CLINICAL NEUROLOGY

Neurologist Pub Date : 2023-09-01 DOI:10.1097/NRL.0000000000000490

Daihui Zhang, Kuopeng Liang, Juntao Yin, Lingtao Tang, Xiaoyi Yang, Zhihong Yang, Xingliang Li

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引用次数: 0

Abstract

Background: Dural arteriovenous fistulas (DAVFs) leading to oedema, primarily in the internal capsule, are extremely rare and, to our knowledge, have never been reported. We reported a case of DAVFs with oedema in bilateral internal capsule oedema and reviewed the literature.

Methods: The report describes a unique imaging presentation of cases of DAVFs as symmetric lesions, mainly in the bilateral internal capsule. It also reviews the literature for symmetric lesions in the internal capsule and central grey matter caused by DAVFs to further characterize this rare entity and differential diagnosis through imaging features.

Results: In cases of symmetric oedema caused by DAVFs, the most common artery involved in arterial supply was the middle meningeal artery (13/24; 54%). The main vein involved in the drainage was the Galen vein (18/29; 62%). Most cases were treated with transarterial embolization (23/29; 79%), and the probability of effective treatment or complete cure is 100%. On imaging, the vasogenic oedema signal caused by DAVFs is a symmetrical lesion of the bilateral internal capsule, that is, DWI MRI shows a high signal in the unrestricted diffusion area on the apparent diffusion coefficient map.

Conclusions: MR has good diagnostic value in abnormal basal ganglia symmetric signals caused by DAVFs, and can quickly identify DAVFs early.

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硬膜动静脉瘘表现为内囊对称病变的影像学研究：一例病例报告和文献复习。

背景：导致水肿的硬脑膜动静脉瘘（DAVFs），主要发生在内囊，极为罕见，据我们所知，从未有报道。我们报告了一例DAVFs合并双侧内囊水肿的病例，并回顾了文献。方法：本报告描述了DAVF病例的独特影像学表现为对称性病变，主要发生在双侧内囊。它还回顾了由DAVFs引起的内囊和中央灰质对称病变的文献，以进一步描述这种罕见的实体并通过影像学特征进行鉴别诊断。结果：在DAVFs引起的对称性水肿病例中，参与动脉供应的最常见动脉是脑膜中动脉（13/24；54%）。参与引流的主要静脉是Galen静脉（18/29；62%）。大多数病例采用动脉栓塞治疗（23/29；79%），有效治疗或完全治愈的概率为100%。在成像上，DAVFs引起的血管源性水肿信号是双侧内囊的对称性病变，即DWI MRI在表观扩散系数图上显示不受限制的扩散区有高信号。结论：MR对DAVFs引起的基底节对称信号异常具有良好的诊断价值，可早期快速识别DAVFs。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologist 医学-临床神经学

CiteScore

1.90

自引率

0.00%

发文量

151

审稿时长

2 months

期刊介绍： The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.