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Case report
Dural arteriovenous fistula presenting with dementia and bulbar symptoms
  1. Christiana Avye Hall1,
  2. David Swienton2 and
  3. Esteban Luis Taleti1
  1. 1Neurology, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2Radiology, University Hospitals of Leicester NHS Trust, Leicester, UK
  1. Correspondence to Dr Esteban Luis Taleti; esteban.taleti{at}nhs.net

Abstract

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.

  • neuroimaging
  • stroke
  • dementia, vascular
  • interventional radiology
  • brain stem / cerebellum
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Footnotes

  • Contributors CAH created the initial manuscript of the case. DS selected and edited the MRI and angiographic sequences and created the corresponding headings. He also contributed in the manuscript review. ELT setup the aims and objectives of the first manuscript as well as reviewed and created the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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