CognardTypeV硬脑膜动静脉瘘的诊断与治疗

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【中图分类号】 R743 【文献标志码】 A 【文章编号】 1672-7770（2025）04-0387-06

Diagnosis and treatment Cognard Type V intracranial dural arteriovenous fistulas LIU Jia ， ZHANG Changwei， NIU Xiaodong，LIU Hao， LI Jin.

Corresponding author ： LI Jin

Abstract： ObjectiveTo investigate the clinical features，imaging features and diagnosis and treatment Cognard Type V inracranial dural arteriovenous fistula（DAVF）. MethodsThe clinical and imaging data 12 patients with Cognard Type V DAVF admitted to Hospital，Sichuan University，from January 2O17 to January 2O25 were retrospectively analyzed. Brain MRI and digital subtraction angiography（DSA） were performed in all patients before operation，and the final diagnosiswas confirmed.The treatment methods were surgical ligation the fistula and interventional embolization. ResultsThe main symptoms were diferent extents paralysis the lower limbs，limb paresthesia and bladder and bowel dysfunction. The main findings MRI were brain stem and cervical spinal cord edema and vascular flow voids on the surface spinal cord. The fistula was located in superior petrosal sinus in 5 cases， the foramen magnum area 7 cases. Blood supply arteries mainly came from the meningohypophysial stem the internal carotid artery，the middle meningeal artery，the ascending pharyngeal artery，and the meningeal branch the vertebral artery. The drainage vein mainly drained through the veins on the surface the brain stem to the anterior and posterior veins the spinal cord.The treatment included surgical resection in 8 cases and interventional embolization in 4 cases. There were no complications. Postoperative follow-up showed symptoms improved in 1O cases （ 83% ），stabilized in 2 cases （17% ），and no aggravation. Postoperative MRI showed that spinal edema subsided to different degrees and vascular empty flow disappeared. ConclusionsCognard Type V DAVF is clinically rare，and is easy to be missed and misdiagnosed because its nonspecific clinical manifestations. Spinal cord edema and vascular flow voids showed on MRI images are important clues for the diagnosis.DSA is stillthe golden standard diagnosis.Early diagnosis and aggressive treatment can prevent irreversible neurological damage.

Key words ： dural arteriovenous fistula ; endovascular embolization ;myelopathy ; spinal venous drainage

颅内硬脑膜动静脉瘘（duralarteriovenousfistula，DAVF）是指颅内供应脑膜的动脉和静脉发生了异常的分流，常见于颅内凸面的硬脑膜、大脑镰、小脑幕以及静脉窦等位置，约占颅内血管畸形的10%～15%[1] 。（剩余9092字）