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持续性动脉静脉:基线认知变化和治疗后的变化:一个前性的纵向研究

Zeev Itsekson-Hayosh¹, Federico Carpani², Pascal J Mosimann^3,4

¹From the Division of Neuroradiology (Z.I.-H., P.J.M., R.A., E.J.H., K.T., T.K., P.N.), University Medical Imaging and Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada zeevits@gmail.com.

AJNR. American journal of neuroradiology

|November 7, 2024

概括

持续性动脉静脉 (DAVF) 经常导致认知障碍,50%的患者受到影响. 在这些患者中,治疗显著改善了70%的认知功能,强调认知是DAVF管理的关键因素.

科学领域:

神经科学是一个神经科学.
血管神经学血管神经学
干预性神经放射学干预性神经放射学

背景情况:

持续性动脉静脉 (DAVFs) 存在各种症状,包括出血和痴呆的风险.
在没有正式的神经认知测试的情况下,DAVF患者的微妙认知变化可能不会被检测到.
了解DAVF对认知的影响对于全面的患者护理至关重要.

研究的目的:

预期评估未破裂的DAVFs患者的基线认知变化.
评估内血管治疗对这些患者认知状态的影响.
确定认知障碍与DAVF特征 (如皮质静脉逆流) 之间的关联.

主要方法:

一项纵向前性研究,涉及23名未破裂的DAVF患者进行栓塞.
在治疗前和后进行神经认知评估,使用可重复的神经心理状态评估电池 (RBANS) 和轨迹测试 (TMT).
进行了神经检查,以与认知发现相关联.

主要成果:

50%的患者在基线表现出认知障碍,显著与皮质静脉逆流相关 (P < .05).
在治疗后,在多个认知领域观察到显著的改善,包括记忆,视觉空间能力,语言和注意力.
RBANS总分数平均提高了8.6分 (P < .001),而TMT完成时间显著减少 (P < .001).

结论:

在DAVF患者中,认知障碍很普遍 (50%),与皮质静脉逆流有关.
内血管治疗导致70%受影响患者的认知能力显著改善,特别是记忆力.
在决定DAVF干预时,应考虑认知结果与出血风险一起.

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