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Neuroradiology

, 51:731 | Cite as

Reversibility of cognitive disorder after treatment of dural arteriovenous fistulae

  • Yutaka KaiEmail author
  • Koichi Ito
  • Tatsuya Kinjo
  • Youhei Hokama
  • Hideki Nagamine
  • Sukemitsu Kushi
  • Shigemasa Kinjo
  • Yukihiro Tsuchida
  • Kouichi Sugimoto
  • Motohiro Morioka
  • Shigetoshi Yano
  • Yuki Ohmori
  • Takayuki Kawano
  • Hideo Nakamura
  • Keishi Makino
  • Jun-ichiro Hamada
  • Jun-ichi Kuratsu
  • Yoshihiko Yoshii
Diagnostic Neuroradiology

Abstract

Introduction

Dural arteriovenous fistulae (DAVF) occasionally lead to cognitive disorders whose reversibility after DAVF treatment remains unclear. We studied changes on pre- and post-treatment magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) scans in ten patients with cognitive disorder due to DAVF.

Methods

We studied the symptoms, pre- and post-treatment MRI scans, SPECT findings, and mini-mental state examination (MMSE) and treatment results in ten patients with cognitive disorder due to DAVF. They were divided into two groups; the post-treatment MMSE score exceeded 25 points in group 1 (n = 6) and was lower than 24 points in group 2 (n = 4).

Results

In the six group 1 patients, pretreatment diffusion-weighted images (DWI) showed hyperintense areas, and SPECT scans demonstrated the preservation of vasoreactivity after acetazolamide challenge. In the four group 2 patients, pretreatment SPECT demonstrated hypoperfusion areas that coincided with the hyperintense areas seen on DWI; there were areas with marked disturbance in vasoreactivity. The post-treatment MMSE score in groups 1 and 2 improved by 13.7 ± 2.4 and 3.8 ± 1.0 points, respectively; the difference was significant at p < 0.01.

Conclusion

In patients with cognitive disorder due to DAVF, the preservation of vasoreactivity on SPECT after acetazolamide challenge indicates that their cognitive disorder may be reversible by DAVF treatment.

Keywords

Cognitive disorder Dural arteriovenous fistula Venous congestion 

Notes

Conflict of interest statement

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Yutaka Kai
    • 1
    • 4
    Email author
  • Koichi Ito
    • 1
  • Tatsuya Kinjo
    • 1
  • Youhei Hokama
    • 1
  • Hideki Nagamine
    • 1
  • Sukemitsu Kushi
    • 1
  • Shigemasa Kinjo
    • 1
  • Yukihiro Tsuchida
    • 1
  • Kouichi Sugimoto
    • 1
  • Motohiro Morioka
    • 2
  • Shigetoshi Yano
    • 2
  • Yuki Ohmori
    • 2
  • Takayuki Kawano
    • 2
  • Hideo Nakamura
    • 2
  • Keishi Makino
    • 2
  • Jun-ichiro Hamada
    • 3
  • Jun-ichi Kuratsu
    • 2
  • Yoshihiko Yoshii
    • 1
  1. 1.Department of Neurosurgery, Graduate School of Medical SciencesRyukyu UniversityOkinawaJapan
  2. 2.Department of Neurosurgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
  3. 3.Department of Neurosurgery, Graduate School of Medical SciencesKanazawa UniversityKanazawaJapan
  4. 4.Department of NeurosurgeryUniversity of the Ryukyu Faculty of MedicineOkinawaJapan

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