Spontaneous Subdural Hematoma and Behavioral Changes Due to a Dural Arteriovenous Fistula. A Case Report and Literature Review
by
Zenaida Milagros Hernández-Díaz 1,*,
Juan Carlos Llíbre-Guerra 2
,
Marianela Arteche-Prior 2,
Tania de la Paz-Bermúdez 1,
Angel Francisco Águila-Ruiz 1,
Luisa María Figueroa-García 2 and
María de los Ángeles Robinson-Agramonte 1
Zenaida Milagros Hernández-Díaz 1,*,
Juan Carlos Llíbre-Guerra 2,
Marianela Arteche-Prior 2,
Tania de la Paz-Bermúdez 1,
Angel Francisco Águila-Ruiz 1,
Luisa María Figueroa-García 2 and
María de los Ángeles Robinson-Agramonte 1
1
Department of Neuroimagenology, International Center for Neurological Restoration, 25th Ave, Playa 15805, Havana 11300, Cuba
2
Department of Endovascular Therapy and Stroke Unit, Institute of Neurology and Neurosurgery, Calle 29 y Esquina D, Havana 10400, Cuba
*
Author to whom correspondence should be addressed.
Behav. Sci. 2019, 9(6), 63; https://doi.org/10.3390/bs9060063
Received: 5 February 2019 / Revised: 17 May 2019 / Accepted: 6 June 2019 / Published: 14 June 2019
(This article belongs to the Special Issue From Basic to Clinical in Behavioral Disorders)
Dural arteriovenous fistulas (DAVFs) represent 10–15% of intracranial arteriovenous malformations. Of these, only 12–29% cause intracranial hemorrhage. The presentation of DAVF as a subdural hematoma (SDH) and intraparenchymal hemorrhage (IPH) is infrequent; additionally, behavioral changes are not common among these patients. We report, for the first time in our country, the case of a 23-year-old man with no history of head injury, in which a brain computed tomography (CT) scan revealed SDH and IPH with behavioral disturbances. The angiotomography showed ecstatic venous vessels, indicating the presence of a DAVF, which was later confirmed by cerebral angiography. Endovascular therapy, which followed the clinical diagnosis, resulted in satisfactory evolution two years after treatment. A review of the literature concerning cases with DAVF and behavioral disturbances is presented. DAVF may lead to cognitive impairment, behavioral changes, and dementia as a result of diffuse white matter and thalamus modifications related to venous ischemia, and it should be considered as a reversible cause of vascular dementia.
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Keywords:
behavioral changes; dural arteriovenous fistula; intracerebral hematoma; subdural hematoma; rare diseases
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MDPI and ACS Style
Hernández-Díaz, Z.M.; Llíbre-Guerra, J.C.; Arteche-Prior, M.; de la Paz-Bermúdez, T.; Águila-Ruiz, A.F.; Figueroa-García, L.M.; Robinson-Agramonte, M.Á. Spontaneous Subdural Hematoma and Behavioral Changes Due to a Dural Arteriovenous Fistula. A Case Report and Literature Review. Behav. Sci. 2019, 9, 63.
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