Multiple dural arteriovenous fistulas causing rapid progressive dementia successfully treated by endovascular surgery: case report.

A 67-year-old female presented with multiple dural arteriovenous fistulas (AVFs) manifesting as dementia rapidly progressing over 2 months. The initial diagnosis was Creutzfeldt-Jakob disease based on the acute clinical course. However, angiography eventually revealed multiple dural AVFs involving the bilateral convexities to the superior sagittal sinus and the right transverse-sigmoid sinus. Endovascular treatment combining arterial and venous embolization in multiple stages proved to be effective, as the hemodynamic pathology improved, and the patient recovered from dementia. The cause of the dementia was thought to be venous hypertension in the deep white matter induced by the dural AVFs. Dural AVFs should be included in the differential diagnosis of rapidly progressive dementia.

[1]  Andreas Charidimou,et al.  A Rapidly Progressive Dementia , 2015 .

[2]  T. Matsushima,et al.  Treatment of dural arteriovenous fistula presenting as typical symptoms of hydrocephalus caused by venous congestion: case report. , 2011, Neurologia medico-chirurgica.

[3]  B. Miller,et al.  Rapidly Progressive Dementia , 2016, Continuum.

[4]  H. Takeuchi,et al.  MRI and SPECT studies of dural arteriovenous fistulas presenting as pure progressive dementia with leukoencephalopathy: a cause of treatable dementia , 2006, European journal of neurology.

[5]  J. Jeng,et al.  Intracranial dural arteriovenous fistulas with or without cerebral sinus thrombosis: analysis of 69 patients , 2004, Journal of Neurology, Neurosurgery & Psychiatry.

[6]  J. Hamada,et al.  Pre- and post-treatment MR imaging and single photon emission CT in patients with dural arteriovenous fistulas and retrograde leptomeningeal venous drainage. , 2003, AJNR. American journal of neuroradiology.

[7]  K. terBrugge,et al.  Clinical Course of Cranial Dural Arteriovenous Fistulas With Long-Term Persistent Cortical Venous Reflux , 2002, Stroke.

[8]  A. Yamaura,et al.  Diffuse white matter changes caused by dural arteriovenous fistula , 2001, Journal of Clinical Neuroscience.

[9]  A. Alpérovitch,et al.  Diagnosis of Creutzfeldt-Jakob disease , 2000, Neurology.

[10]  J. Deveikis.  Venous hypertensive encephalopathy. , 1998, AJNR. American journal of neuroradiology.

[11]  J. Trojanowski,et al.  Dementia resulting from dural arteriovenous fistulas: the pathologic findings of venous hypertensive encephalopathy. , 1998, AJNR. American journal of neuroradiology.

[12]  G. Debrun,et al.  Reversibility of white matter changes and dementia after treatment of dural fistulas. , 1995, AJNR. American journal of neuroradiology.

[13]  L. Pierot,et al.  Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. , 1995, Radiology.

[14]  D. Mikulis,et al.  Venous congestion: an MR finding in dural arteriovenous malformations with cortical venous drainage. , 1994, AJNR. American journal of neuroradiology.