Joshua Lai1, Manraj K S Heran2, A Jon Stoessl1, Peter A Gooderham3. 1. Department of Neurology University of British Columbia Vancouver British Columbia Canada. 2. Department of Radiology University of British Columbia Vancouver British Columbia Canada. 3. Department of Neurosurgery University of British Columbia Vancouver British Columbia Canada.
Abstract
BACKGROUND: Dural arteriovenous fistula (dAVF) rarely presents with a syndrome of reversible parkinsonism and rapidly progressive dementia, which has been described in 19 patients to date. However, its presenting features, pathophysiology, and response to treatment have not been reviewed. METHODS: We report the clinical course and treatment of two novel patients with this syndrome. RESULTS: Despite severe presentations, both patients recovered fully after fistula obliteration. CONCLUSIONS: Atypical parkinsonism with early cognitive changes and other focal neurological signs, along with features such as pulsatile tinnitus or worsening headache, should raise the possibility of dAVF. When treated, this syndrome is nearly always reversible, highlighting the importance of early diagnosis.
BACKGROUND: Dural arteriovenous fistula (dAVF) rarely presents with a syndrome of reversible parkinsonism and rapidly progressive dementia, which has been described in 19 patients to date. However, its presenting features, pathophysiology, and response to treatment have not been reviewed. METHODS: We report the clinical course and treatment of two novel patients with this syndrome. RESULTS: Despite severe presentations, both patients recovered fully after fistula obliteration. CONCLUSIONS: Atypical parkinsonism with early cognitive changes and other focal neurological signs, along with features such as pulsatile tinnitus or worsening headache, should raise the possibility of dAVF. When treated, this syndrome is nearly always reversible, highlighting the importance of early diagnosis.
Entities:
Keywords:
dementia; direct sinus puncture; dural arteriovenous fistula; parkinsonism; reversible
Authors: Conor Fearon; Sapna Rawal; Diana Olszewska; Paula Alcaide-Leon; Drew S Kern; Soumya Sharma; Shyam K Jaiswal; Jagarlapudi M K Murthy; Ainhi D Ha; Raymond S Schwartz; Victor S C Fung; Chauncey Spears; Tracy Tholanikunnel; Leonardo Almeida; Taku Hatano; Yutaka Oji; Nobutaka Hattori; Shantanu Shubham; Hrishikesh Kumar; Roongroj Bhidayasiri; Christopher Laohathai; Anthony E Lang Journal: Mov Disord Clin Pract Date: 2022-02-03