Cognitive impairment with bithalamic venous congestion caused by falco-tentorial dural arteriovenous fistula

Abstract

An 83-year-old male exhibited cognitive impairment and deteriorated in few days. MRI T2WI and FLAIR image showed high signal intensity and low signal intensity on T2^*WI in the thalami. Angiographical images showed small dural arteriovenous fistula at the falco-tentorial junction with straight sinus thrombosis. A part of the venous drainage refluxed and congested to the area of bilateral internal cerebral vein. Based on these findings, the venous congestion of thalami caused the patient to cognitive decline. The dural arteriovenous fistula was treated by transvenous embolization with coil via occluded straight sinus. The cognitive function of the patient made a remarkable recovery about 1 month after the embolization. We report a rare case of cognitive dysfunction with bithalamic lesion caused by falco-tentorial dural arteriovenous fistula with thrombosed straight sinus.