A case of dural arteriovenous fistula presented with cognitive symptoms and improved with endovascular treatment

<p>Introduction: Dural arteriovenous fistula (DAVF), also known as dural arteriovenous malformation, accounts for 10% to 15% of intracranial vascular anomalies. DAVF causes diverse symptoms based on the location of the shunt and hemodynamics, occasionally manifesting as cognitive impairment. The incidence of cognitive symptoms in patients with DAVF reportedly ranges from 1.6% to 12.0%. In this report, we describe a DAVF case that presented with cognitive symptoms and improved through endovascular therapy.</p><p>Case: A 73-year-old woman sought medical attention at our institution because of episodic vertigo and gradual progression of cognitive decline. DAVF was identified in the transverse and sigmoid sinuses and was accompanied by severe venous stasis. After two sessions of endovascular treatment, a marked reduction in shunt flow was observed, leading to improvements in the patient’s cognitive function and activities of daily living.</p><p>Discussion: DAVF is an important etiology of cognitive impairment. Notably, DAVF can also cause cerebral hemorrhage with life-threatening consequences. Early diagnosis and therapeutic intervention are crucial to ameliorate cognitive symptoms through appropriate management.</p>