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Five(12.5%)of 40 consecutive patients with DAVFs had encephalopathy or dementia.In each patient,high flow through the arteriovenous shunt combined with venous outflow obstruction caused impairment of cerebral venous damage.Hemodynamically,the result was widespread venous hypertension causing diffuse ischemia and progressive dysfunction of brain parenchyma.Results of CT or MIR imaging revealed abnormalities in each patient,reflecting the impaired parenchymal venous drainage.Pathologic findings in one patient confirmed the mechanism of cerebral dysfunction as venous hypertension.The hemodynamic mechanism and resulting abnormality appeared identical to that seen in progressive chronic myelopathy resulting from a spinal DAVF(Fiox-Alajouainine syndrome).Remission of cognitive symptoms occurred in each patient after embolization.Venous hypertensive encephalopathy resulting from a DAVF should be considered a potentially reversible cause of vascular dementia in patients with progressive cognitive deficits. |
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angiography,cerebral bruit bruit,cranial CAT scan CAT scan,abnormal confusion dementia dementia,cerebrovascular disease causing dementia,rapidly progressive encephalopathy fistula,arterio-venous fistula,arterio-venous,dural headache hypertensive encephalopathy hypertensive encephalopathy,venous malformation,vascular malformation,vascular,cerebral malformation,vascular,treatment of memory,impairment of MRI MRI,abnormal treatment of neurologic disorder venous hypertension
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