硬脑膜动静脉瘘的头痛表型及可能机制

硬脑膜动静脉瘘是发生在颅内硬脑膜动脉和静脉之间异常交通的脑血管畸形。头痛作 为其常见症状，临床表型多样，可表现为偏头痛样头痛和非偏头痛样头痛，并常伴有搏动性耳鸣、眼 肌麻痹等，为诊断增加了难度。目前DSA仍然是硬脑膜动静脉瘘诊断和表征的“金标准”。保守治疗 和血管内栓塞治疗减少硬脑膜动静脉瘘分流可有效缓解头痛症状。本文旨在对硬脑膜动静脉瘘的头 痛表型特征、可能机制及治疗转归进行综述。

Headache Phenotypes and Possible Mechanisms of Dural Arteriovenous Fistula

Dural arteriovenous fistula is an intracranial vascular malformation, typified byabnormal communication between meningeal arteries and dural venous sinuses or cortical veins.Headache is a common symptom with various clinical phenotypes, which makes the diagnosismore difficult. It can be manifested as migraine-like headache or non-migraine-like headache, oftenaccompanied by pulsing tinnitus or ophthalmoplegia. At present, DSA is still the gold standardfor diagnosis and characterization of dural arteriovenous fistula. Conservative treatment andendovascular embolization to reduce the shunt of dural arteriovenous fistula can effectively relieve headache symptoms. This article aimed to review the headache phenotypes, possible mechanismsand treatment outcomes of dural arteriovenous fistulas.