误诊为感音性耳聋及颈动静脉瘘的硬脑膜动静脉瘘

目的提高对硬脑膜动静脉瘘(dural arteriovenous fistula,DAVF)的认识及诊断水平。方法回顾性分析1例DAVF误诊病例资料。结果本例因右侧耳鸣1年余就诊,发病前曾发生交通事故,当时无外伤。1年前出现持续性右侧耳鸣,在当地医院耳鼻咽喉科误诊为感音性耳聋,予相应治疗症状无改善,后因症状加重,在当地医院经头颅螺旋CT动脉造影检查再次误诊为颈动静脉瘘。转我院后经彩色多普勒超声和数字减影血管造影检查确诊为DAVF。全身麻醉下行右侧DAVF瘘口栓塞术痊愈。随访2个月无复发。结论 DAVF发病初期可以单纯耳鸣、耳聋为表现,临床及影像医生应提高对本病的认识,及早行相关影像学检查以减少误诊误治。

Dural Arteriovenous Fistula Misdiagnosed as Sensorineural Hearing Loss and Neck Arteriovenous Fistula

Objective To improve the awareness and diagnostic capability of dural arteriovenous fistula （DAVF）. Methods Clinical data of one misdiagnosed patient with DAVF was retrospectively analyzed. Results The patient visited a doctor for the right tinnitus for more than one year, and the patient had a traffic accident in the earlier time, but the patient suffered no injury at that time. The patient had continuous right tinnitus one year ago, and was misdiagnosed as having senso-rineural hearing loss in other hospitals. The symptom was aggravating after corresponding treatment, and the patient was misdi-agnosed as having neck arteriovenous fistula after the head CT angiography （CTA） examination in the same hospital. DAVF was confirmed by color Doppler examination and digital subtraction angiography after the patient was transferred to our hospi-tal. The patient was cured by the right DAVF fistula embolization under general anaesthesia, and there was no recurrence within 2 months of follow-up. Conclusion DAVF may have simple tinnitus or hearing loss in the primary stage, so clinicians and radiological physicians should increase awareness of the disease and perform related iconography examinations in order to avoid misdiagnosis and mistreatment.