和歌山県下における硬膜動静脈瘻の頻度と特徴

概要

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We report the clinical characteristics, treatment, and detection rate of dural arteriovenous fistulas (DAVF) in a Wakayama Prefecture study. Between January 1989 and December 2008, 134 patients with DAVF were hospitalized in Wakayama Prefecture: 88 women and 46 men (mean age 63.5 years; range, 11–82). The crude detection rate (per 100,000 persons per year) was 1.06 in Wakayama. Clinical presentations were diplopia/chemosis (32.3%), pulsatile tinnitus (25.6%), hemorrhage (14%), headache/dementia (8.3%), radiculopathy (5.0%), and incidental (10%). The locations of DAVF were cavernous (38.0%), transverse-sigmoid (32.1%), spinal (8.2%), craniocervical (6.7%), superior sagittal sinus (6.0%), tentorium (5.2%), and anterior cranial fossa (2.3%). Most patients (86.5%) underwent endovascular treatment. Complete shunt obliteration was achieved in 67% of the patients, almost complete occlusion in 26% and shunt reduction in 6.6%. The cumulative complication rate was 8.1% (n=15), with minor adverse events in 10 patients and major complications in four patients (2.2%). The detection rate of DAVF was higher in our series than in previous reports. We hypothesize that availability of high spatial and resolute MRI in the screening contributed to the increased detection rate of DAVF.
一般社団法人日本脳卒中の外科学会の論文