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KMID : 0911820140150010022
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Korean Journal of Headache
2014 Volume.15 No. 1 p.22 ~ p.24
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Cognard Type IIa Dural Arteriovenous Fistula with Increased Intracranial Pressure and Papilledema
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Kim Jun-Pyo
Park Hea-Ree
Kim Suk-Jae
Jeon Pyoung
Kim Jong-Soo
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Abstract
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Clinical presentations of dural arteriovenous fistulas (AVFs) vary significantly from asymptomatic to fatal according to location and radiological features. Cognard type IIa fistula, characterized by the presence of retrograde drainage into venous sinus and absence of cortical venous reflux, is infrequently associated with severely increased intracranial pressure (ICP) or papilledema. Herein, we report a patient with dural AVF with increased ICP and papilledema. The patient complained of headache, pulsatile tinnitus and visual disturbance. The symptoms were not relieved by thiazide and carbonic anhydrase inhibitor. After repeated coil embolization with transvenous approach, although pulsatile tinnitus persisted, headache nearly disappeared (Numeric rating scale 0-1) immediately and ICP decreased from 40 cmH2O to 22.5 cmH2O. Follow-up ophthalmologic evaluation revealed marked improvement of papilledema and visual field.
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KEYWORD
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Dural arteriovenous fistula, Intracranial hypertension, Papilledema, Headache
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