Neuropsychological Features of Dementia due to Dural Arteriovenous Malformation

Jaillard, Assia; Peres, Blandine; Hommel, Marc

doi:10.1159/000015904

Cited by 12 publications

(4 citation statements)

References 23 publications

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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%

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%

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

Holekamp

Mollman

Murphy

et al. 2016

JNS

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“…Closure of the dAVM either surgically or through an endovascular approach is obligatory. Partial treatment will lead to recurrence of symptoms and will sometimes not prevent death 4,7 . When partial treatment can be achieved through an arterial route this is preferable, but if this can not be accomplished, occlusion of the sinus at the fistulous point is necessary.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Type III Dural Arteriovenous Malformation: Correlation with Neuropsychological Disturbances

et al. 2002

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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%