title: Reversibility of cognitive disorder after treatment of dural arteriovenous fistulae.
abstract: BACKGROUND
  Dural arteriovenous fistulae (DAVF) occasionally lead to cognitive disorders whose reversibility after DAVF treatment remains unclear. We studied changes on pre- and post-treatment magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) scans in ten patients with cognitive disorder due to DAVF.
  
  
  METHODS
  We studied the symptoms, pre- and post-treatment MRI scans, SPECT findings, and mini-mental state examination (MMSE) and treatment results in ten patients with cognitive disorder due to DAVF. They were divided into two groups; the post-treatment MMSE score exceeded 25 points in group 1 (n = 6) and was lower than 24 points in group 2 (n = 4).
  
  
  RESULTS
  In the six group 1 patients, pretreatment diffusion-weighted images (DWI) showed hyperintense areas, and SPECT scans demonstrated the preservation of vasoreactivity after acetazolamide challenge. In the four group 2 patients, pretreatment SPECT demonstrated hypoperfusion areas that coincided with the hyperintense areas seen on DWI; there were areas with marked disturbance in vasoreactivity. The post-treatment MMSE score in groups 1 and 2 improved by 13.7 +/- 2.4 and 3.8 +/- 1.0 points, respectively; the difference was significant at p < 0.01.
  
  
  CONCLUSIONS
  In patients with cognitive disorder due to DAVF, the preservation of vasoreactivity on SPECT after acetazolamide challenge indicates that their cognitive disorder may be reversible by DAVF treatment.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Sciences, Ryukyu University, Okinawa, Japan. ykai@med.u-ryukyu.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kai
authors.forename: Koichi
authors.initials: K
authors.lastname: Ito
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kinjo
authors.forename: Youhei
authors.initials: Y
authors.lastname: Hokama
authors.forename: Hideki
authors.initials: H
authors.lastname: Nagamine
authors.forename: Sukemitsu
authors.initials: S
authors.lastname: Kushi
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Kinjo
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Tsuchida
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Motohiro
authors.initials: M
authors.lastname: Morioka
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yano
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ohmori
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawano
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakamura
authors.forename: Keishi
authors.initials: K
authors.lastname: Makino
authors.forename: Jun-ichiro
authors.initials: J
authors.lastname: Hamada
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kuratsu
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yoshii
mesh_terms: D000086:Acetazolamide; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D002533:Cerebral Angiography; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D000086:Acetazolamide
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