[Papilledema and dural fistula].
A retrospective analysis of three cases of papilledema was made, initially attributed to idiopathic raised intracranial pressure on the basis of the following data: symptoms and signs of raised intracranial pressure, no other neurological signs, normal electroencephalogram, normal computerised tomography, and normal cerebrospinal fluid. The discovery of a dural arteriovenous malformation was made only after a period over six months, by cerebral angiography. After a survey of medical data concerning the incidence of papilledema in dural fistulae, a description of the supposed pathogenic mechanisms of papilledema formation in this disease is proposed. Venous hypertension was found to be the main factor leading to papilledema. It could be in relation with obstruction of the involved venous sinus, and with the high level of blood flow of the dural arteriovenous malformation. It appeared that drainage with involvement of subarachnoid veins was the main characteristic for arteriovenous malformations to be directly responsible for papilledema. The possible lack or delay of suggestive signs such as intracranial bruit and the potential seriousness of the vital and visual prognosis led us to routinely carry out angiologic investigations comprising first doppler ultra-sound of the cervical vessels and secondly cerebral angiography, before diagnosing benign raised intracranial pressure.
Rozot
P
P
Service d'Ophtalmologie A, Hôpital Central, Nancy.
Berrod
J P
JP
Bracard
S
S
Roy
D
D
Vespignani
H
H
D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications* / Q000503:physiopathology; D004388:Dura Mater / Q000098:blood supply*; D004621:Embolization, Therapeutic; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000503:physiopathology; D008297:Male; D010211:Papilledema / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D011559:Pseudotumor Cerebri / Q000209:etiology; D012189:Retrospective Studies
Stase papillaire et fistule durale.