Open AccessDural arteriovenous fistula presenting with dementia and bulbar symptoms
Author(s) -
Christiana Avye Hall,
David Swienton,
Esteban Luis Taleti
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-234907
Subject(s) - medicine , arteriovenous fistula , dementia , presentation (obstetrics) , neurology , surgery , radiological weapon , radiology , venous hypertension , arteriovenous malformation , disease , psychiatry
Dural arteriovenous fistulas are relatively rare. Some cases are difficult to diagnose, leading to unnecessary investigations, treatments and delays, particularly if the presentation is atypical. We report a case of a man who presented with progressive dementia and bulbar symptoms, both under-recognised non-haemorrhagic neurological deficits, caused by cortical venous hypertension. Brain imaging showed unusual bilateral thalamic, tectal plate and midbrain oedema. The patient was investigated and treated for alternative aetiologies, before being correctly diagnosed and managed using angiographic embolisation. His clinical and radiological signs improved significantly following treatment, reducing his risk of neurological morbidity and mortality.