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Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA
BACKGROUND: The diagnosis of transient ischemic attack (TIA) based on clinical history and objective findings, even including multiparametric MRI, can be misleading. We report two patients who presented with TIA-like deficits with isolated perfusion lesions in corresponding areas but were finally di...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495893/ https://www.ncbi.nlm.nih.gov/pubmed/22905952 http://dx.doi.org/10.1186/1471-2377-12-77 |
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author | Kim, Yong-Won Kang, Dong-Hun Hwang, Yang-Ha Park, Sung-Pa |
author_facet | Kim, Yong-Won Kang, Dong-Hun Hwang, Yang-Ha Park, Sung-Pa |
author_sort | Kim, Yong-Won |
collection | PubMed |
description | BACKGROUND: The diagnosis of transient ischemic attack (TIA) based on clinical history and objective findings, even including multiparametric MRI, can be misleading. We report two patients who presented with TIA-like deficits with isolated perfusion lesions in corresponding areas but were finally diagnosed as transient neurological symptoms associated with dural arteriovenous fistula (dAVF). CASE PRESENTATION: Two patients presented with transient focal neurological symptoms lasting less than one hour. An isolated perfusion deficit with no diffusion change in the clinically relevant area was shown on brain MRI, indicating transient ischemia as the most plausible cause of neurological symptoms. However, cerebral angiography let to diagnosis of dAVF in both cases. Intracerebral hemorrhage occurred after the initial diagnosis of TIA in one patient, and the small area of perfusion abnormality accompanied by the enlarged cortical vein in the other case helped to identify the dAVF through the further investigation. The pattern of perfusion-weighted imaging in both cases revealed increase of mean transit time and relative cerebral blood volume denoting the venous congestion in a clinically corresponding area. CONCLUSION: Reported cases are uncommon clinical presentation of a dAVF, which can be misdiagnosed as TIA on clinical grounds. In rare cases, the isolated perfusion deficits could be attributable to venous congestion, despite the similar pattern of clinical presentation, such as with TIA. |
format | Online Article Text |
id | pubmed-3495893 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34958932012-11-13 Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA Kim, Yong-Won Kang, Dong-Hun Hwang, Yang-Ha Park, Sung-Pa BMC Neurol Case Report BACKGROUND: The diagnosis of transient ischemic attack (TIA) based on clinical history and objective findings, even including multiparametric MRI, can be misleading. We report two patients who presented with TIA-like deficits with isolated perfusion lesions in corresponding areas but were finally diagnosed as transient neurological symptoms associated with dural arteriovenous fistula (dAVF). CASE PRESENTATION: Two patients presented with transient focal neurological symptoms lasting less than one hour. An isolated perfusion deficit with no diffusion change in the clinically relevant area was shown on brain MRI, indicating transient ischemia as the most plausible cause of neurological symptoms. However, cerebral angiography let to diagnosis of dAVF in both cases. Intracerebral hemorrhage occurred after the initial diagnosis of TIA in one patient, and the small area of perfusion abnormality accompanied by the enlarged cortical vein in the other case helped to identify the dAVF through the further investigation. The pattern of perfusion-weighted imaging in both cases revealed increase of mean transit time and relative cerebral blood volume denoting the venous congestion in a clinically corresponding area. CONCLUSION: Reported cases are uncommon clinical presentation of a dAVF, which can be misdiagnosed as TIA on clinical grounds. In rare cases, the isolated perfusion deficits could be attributable to venous congestion, despite the similar pattern of clinical presentation, such as with TIA. BioMed Central 2012-08-20 /pmc/articles/PMC3495893/ /pubmed/22905952 http://dx.doi.org/10.1186/1471-2377-12-77 Text en Copyright ©2012 Kim et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Kim, Yong-Won Kang, Dong-Hun Hwang, Yang-Ha Park, Sung-Pa Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA |
title | Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA |
title_full | Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA |
title_fullStr | Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA |
title_full_unstemmed | Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA |
title_short | Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA |
title_sort | unusual mri findings of dural arteriovenous fistula: isolated perfusion lesions mimicking tia |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495893/ https://www.ncbi.nlm.nih.gov/pubmed/22905952 http://dx.doi.org/10.1186/1471-2377-12-77 |
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