An improper connection between an artery and a vein in the tough covering over the brain or spinal cord is known as a dural arteriovenous fistula (dAVF). The brain, spinal cord, and other parts of your body may have abnormal pathways between arteries and veins.
Dural AVFs are more common later in life, and they aren’t usually passed down genetically. This means that children aren’t more likely to develop a dAVF simply because one of their parents has.
Even though some dAVFs have a known aetiology, it is suspected that dAVFs involving major brain veins are caused by a narrowing or blockage of one of the brain’s venous sinuses, which ordinarily carry circulating blood back to the heart.
Some patients with a dAVF don’t show any signs or symptoms at all. Manifested symptoms, on the other hand, can be classified as aggressive or benign. Brain bleeding (intracerebral haemorrhage) or neurological repercussions of non-hemorrhaging neurological impairments can cause aggressive dAVF symptoms (NHNDs).
Depending on the location and amount of the haemorrhage, bleeding in the brain can induce a sudden onset headache with varied degrees of neurological impairment. An NHND, on the other hand, normally develops over days to weeks and creates a set of symptoms that are related to its location.
Seizures, speech or language difficulty, face pain, dementia, Parkinsonism, coordination challenges, burning or prickling sensations, weakness, apathy, failure to thrive, and symptoms connected to increasing pressure including headaches, nausea, and vomiting are all examples of aggressive symptoms.
Hearing problems (typically a bruit behind the ear, also known as pulsatile tinnitus) and vision problems, such as visual degeneration, eye bulge, swelling in the eye lining, eye-related palsies, and cavernous sinus syndrome, are more mild dAVF symptoms. Venous hypertension can cause progressive dementia in rare circumstances.
Although some are caused by identified causes such as traumatic head injury, infection, previous brain surgery, or malignancies, the majority of dural arteriovenous fistulas have no obvious explanation. Most experts believe that dAVFs in the bigger brain veins are caused by a progressive narrowing or blockage of one of the brain’s venous sinuses, which carry circulating blood back to the heart.
Those predisposed to vein thrombosis, such as coagulation disorders that enhance the probability of venous sinus occlusion, are genetic risk factors for dAVFs. People in their late middle years are the most commonly affected by dAVFs (roughly from 50 to 60 years old). dAVFs, on the other hand, can affect people of all ages, including youngsters.
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