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目的提高临床对双侧硬脑膜动静脉瘘的诊断意识。方法回顾性描述1例双侧硬脑膜动静脉瘘患者的临床表现、诊疗经过,结合文献报道对双侧丘脑梗死的发病机制、临床表现和诊疗进行探讨。结果患者为老年女性,以右眼青光眼为首发症状就诊于眼科,常规治疗后未见好转,转入神经内科行脑血管造影后示双侧硬脑膜动静脉瘘。结论临床工作中诊疗以青光眼起病但常规治疗方法欠佳时,应考虑硬脑膜动静脉瘘可能,减少误诊率,改善预后。
Objective To improve the clinical diagnosis of bilateral dural arteriovenous fistula awareness. Methods The clinical manifestations, diagnosis and treatment of one case of bilateral dural arteriovenous fistula were retrospectively reviewed. The pathogenesis, clinical manifestations and diagnosis and treatment of bilateral thalamic infarction were discussed in the literature. Results The patients were elderly women. The first symptom of right eye glaucoma was treated in ophthalmology. No improvement was found after routine treatment. The patients were referred to neurology department for bilateral dural arteriovenous fistula after cerebral angiography. Conclusions In clinical work, when glaucoma is diagnosed and the routine treatment is not satisfactory, the possibility of dural arteriovenous fistula should be considered, the rate of misdiagnosis reduced, and prognosis improved.