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. 2024 Apr 1;94(4):771-779.
doi: 10.1227/neu.0000000000002748. Epub 2023 Nov 6.

Dural Arteriovenous Fistulas With or Without Cerebral Venous Thrombosis: A Cross-Sectional Analysis of 511 Patients

Shuling Wan  1   2 , Guangyu Han  1   2 , Xiangqian Huang  1   2 , Yibing Guo  1   2 , Jian Chen  3 , Da Zhou  1   2 , Chuanjie Wu  1   2 , Xunming Ji  1   2   3 , Yuchuan Ding  4   5 , Ran Meng  1   2   4
Affiliations

Dural Arteriovenous Fistulas With or Without Cerebral Venous Thrombosis: A Cross-Sectional Analysis of 511 Patients

Shuling Wan et al. Neurosurgery. .

Abstract

Background and objectives: Recent studies suggest a bidirectional relationship of dural arteriovenous fistula (DAVF) with cerebral venous thrombosis (CVT). We aimed to compare the characteristics of patients with DAVF with or without CVT and to analyze the risk factors for the coexistence of CVT in a DAVF population.

Methods: A total of 511 adult patients with DAVF were enrolled consecutively in our hospital from February 2019 through November 2022. Demographic data, clinical manifestations, and imaging characteristics were reviewed in detail. The patients with DAVF were divided into two groups: DAVF with CVT (DAVF-CVT) group and without CVT (DAVF alone) group. Univariate logistic regression and multivariate logistic regression were used to analyze the risk factors for the coexistence of CVT and DAVF.

Results: CVT was found in 19.8% of patients with DAVF. In univariate analysis, compared with the DAVF-alone group, the DAVF-CVT group was more likely to have tinnitus ( P = .001), blurred vision ( P < .001), visual field loss ( P = .001), focal neurological deficits ( P = .002), seizures ( P = .008), and cognitive impairment ( P = .046) and less likely to have spinal cord/brain stem dysfunction ( P = .004). In addition, there were significant differences in age ( P = .009), sex ( P = .019), the occurrence of venous cerebral infarction ( P = .001), and DAVF location ( P < .001) between the two groups. Furthermore, multivariate analysis showed that blurred vision, venous cerebral infarction, large sinus DAVF, and multiple DAVF were risk factors for the coexistence of CVT in patients with DAVF, with the odds ratio of 2.416 (95% CI 1.267-4.606, P = .007), 6.018 (95% CI 1.289-28.100, P = .022), 5.801 (95% CI 2.494-13.496, P < .001), and 5.640 (95% CI 2.122-14.989, P = .001), respectively.

Conclusion: CVT occurred in approximately one fifth of patients with DAVF. Blurred vision, venous cerebral infarction, large sinus DAVF, and multiple DAVF may be the risk factors for predicting the coexistence of CVT in patients with DAVF.

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Figures

None
Graphical abstract
FIGURE 1.
FIGURE 1.
Flow diagram of the study. AVM, arteriovenous malformation; CVT, cerebral venous thrombosis; DAVF, dural arteriovenous fistula; DSA, digital subtraction angiography.
FIGURE 2.
FIGURE 2.
Sex and age distribution of patients with DAVF with and without CVT: A, DAVF-alone group and B, DAVF-CVT group. CVT, cerebral venous thrombosis; DAVF, dural arteriovenous fistula.
FIGURE 3.
FIGURE 3.
Clinical symptom spectrum of patients with DAVF with and without CVT. CVT, cerebral venous thrombosis; DAVF, dural arteriovenous fistula.
See this image and copyright information in PMC

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