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Related Experiment Video

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Technical Aspects of the Mouse Aortocaval Fistula
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[Dural arteriovenous fistula causing complex visual hallucinations without an anopsia].

Shingo Koide1, Masahiro Hatakeyama1, Masahiro Uemura1

  • 1Department of Neurology, Brain Research Institute, Niigata University.

Rinsho Shinkeigaku = Clinical Neurology
|May 22, 2020
PubMed
Summary

This case study reveals that dural arteriovenous fistulas can cause complex visual hallucinations, even when limited to one visual field. Treatment via embolization resolved the patient's symptoms, highlighting a novel cause for visual disturbances.

Keywords:
complex visual hallucinationdural arteriovenous fistulaepilepsytransarterial embolization

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Area of Science:

  • Neurology
  • Neuroradiology
  • Neuroophthalmology

Background:

  • Complex visual hallucinations are typically associated with bilateral visual field involvement or hemianopsia.
  • Dural arteriovenous fistulas (dAVFs) are abnormal connections between dura mater arteries and venous sinuses.

Observation:

  • A 76-year-old woman experienced recurrent complex visual hallucinations solely in her right visual field without anopsia.
  • EEG revealed left parietotemporal sharp transients; MRI showed left temporo-occipital lesions.
  • Cerebral angiography identified a left occipital artery to transverse sinus arteriovenous shunt with cortical venous reflux.

Findings:

  • Transarterial embolization successfully resolved the complex visual hallucinations.
  • The findings suggest the hallucinations were caused by epileptic seizures or altered cortical blood flow due to venous reflux from the dAVF.
  • This case demonstrates that dAVFs can induce unilateral visual hallucinations without hemianopia.

Implications:

  • This study expands the understanding of visual disturbances caused by dural arteriovenous fistulas.
  • It highlights the importance of considering dAVFs in the differential diagnosis of unilateral complex visual hallucinations.
  • The findings suggest that embolization is an effective treatment for dAVF-induced visual hallucinations.