概述
硬脑膜动静脉瘘（dAVF）是动脉和静脉之间的不规则连接。它们发生在脑或脊髓上的硬质覆盖层（称为硬脑膜）中。动脉和静脉之间的不规则通道称为动静脉瘘，可能会导致脑出血或其他严重症状。
硬脑膜 AVF 很罕见。该状况往往发生在 50 至 60 岁之间。该状况通常不具有遗传性，因此如果孩子的父母患有 dAVF，孩子发生该状况的可能性不会更高。
尽管有些 dAVF 来源于已知病因，但最常见的病因不详。人们认为，当一个脑静脉窦变窄或阻塞时，会形成涉及脑静脉的 dAVF。静脉窦是将血液从脑传回心脏的通道。
dAVF 的治疗通常包括血管内手术或立体定向放射外科治疗，以阻断流向 dAVF 的血流。或者，可能需要手术来切断或切除 dAVF。
症状
Symptoms of dural arteriovenous fistulas (dAVFs) can be different for each person, depending on where the dAVFs are located. Some people with dAVFs may not have symptoms. When symptoms occur, they may be characterized as benign or aggressive. An aggressive dAVF has more serious symptoms.
Aggressive dAVF symptoms can result from bleeding in the brain, known as intracerebral hemorrhage. Bleeding in the brain often causes a sudden headache. It also may cause other symptoms based on the location and size of the hemorrhage.
Aggressive symptoms also may result from nonhemorrhagic neurological deficits (NHNDs), which can include seizures or changes in thinking and memory. These symptoms usually develop more gradually, over days to weeks. Symptoms are typically related to the area of the brain affected.
Aggressive symptoms can include:
- Sudden headache.
- Trouble walking and falls.
- Seizures.
- Speech or language issues.
- Facial pain.
- Dementia.
- Slowed movement, stiffness and tremor, known as parkinsonism.
- Trouble with coordination.
- Burning or prickling sensations.
- Weakness.
- Lack of interest, known as apathy.
- Failure to thrive.
- Symptoms related to increased pressure, such as headaches, nausea and vomiting.
Other dAVF symptoms can include hearing issues. People with hearing symptoms may hear a rhythmic sound in the ear that occurs with the heartbeat, known as pulsatile tinnitus. Symptoms also may include trouble with vision, such as:
- Vision changes.
- Eye bulge.
- Swelling in the eye lining.
- Paralysis of a muscle in or around the eye.
Rarely, dementia may occur due to increased pressure in the blood vessels in the brain.
何时就医
如果出现任何不寻常或令人担忧的症状，请与医疗护理专业人员约诊。
如果您出现任何癫痫发作或以下提示脑出血的症状，请立即寻求医疗帮助，例如：
- 突发剧烈头痛。
- 恶心。
- 呕吐。
- 身体一侧无力或麻木感。
- 说话或理解言语问题。
- 视力丧失。
- 复视。
- 平衡问题。
病因
大多数硬脑膜动静脉瘘（dAVF）都没有明确的起源。但有些是由创伤性头部受伤、感染、既往脑部手术、深静脉血凝块或肿瘤引起的。
大多数专家认为，涉及较大脑静脉的 dAVF 是由于其中一个脑静脉窦变窄或阻塞所致。静脉窦是脑内的通道，负责将循环后的血液从脑输送回心脏。
风险因素
硬脑膜动静脉瘘（dAVF）的风险因素包括容易出现静脉血凝块，称为静脉血栓形成。血凝块的变化可能会增加静脉窦阻塞或狭窄的风险。
dAVF 最常影响 50 至 60 岁之间的人群。但它们也可能发生在年龄较小的人群中，包括儿童。
研究发现，在围绕脑和脊髓的膜中发现的非癌性肿瘤可能与 dAVF 相关。
Nov. 26, 2024