Dural Arteriovenous Fistulas: Baseline Cognitive Changes and Changes following Treatment: A Prospective Longitudinal Study

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Download figure
Open in new tab
Download powerpoint
FIG 1.
The heat map shows individual patient cognitive performance pre- and posttreatment across various RBANS domains. Green shades indicate improvement, while red shades indicate declines. Darker colors represent more significant changes. The numeric values reflect deviations from average standardized scores, with positive values indicating above-average performance and negative values indicating below-average performance. These provide a visual representation for baseline values and outcomes for each patient pre- and posttreatment, as well as for the entire cohort.
Download figure
Open in new tab
Download powerpoint
FIG 2.
Diagnostic cerebral angiographies (left external carotid artery selective injections) showing a representative patient who presented with a low-grade DAVF (ie, no cortical venous reflux) and cognitive impairment, which improved following endovascular disconnection of the shunt. AP indicates anterior-posterior.

Cognitive performance of patients with DAVF, before and after endovascular embolization, stratified according to presence of CVR^a

	Patients with CVR			Patients without CVR
	Baseline (mean) (SD)% Impaired	Posttreatment(mean) (SD)% Impaired	Reliable Change% above Cutoff	Baseline (mean) (SD)% Impaired	Posttreatment(mean) (SD)% Impaired	Reliable Change% above Cutoff
RBANS total	87.7	95.5		86.8	103.3
	14.98	13.46		14.89	10.50
	28%	23%	24%	20%	0%	25%
RBANS Immediate Memory	82.9	94.6		79.0	103.5
	18.72	15.03		15.60	11.79
	39%	23%	35%	40%	0%	75%
RBANS Delayed Memory	87.3	95.8		86.0	101.8
	22.49	16.14		24.46	14.17
	33%	18%	24%	20%	0%	0%
RBANS Visuo spatial	94.3	91.6		93.8	100.8
	11.58	18.04		18.05	3.77
	22%	41%	0%	40%	0%	0%
RBANS Language	91.1	98.2		95.8	100.5
	9.63	14.75		13.92	16.60
	22%	6%	12%	20%	25%	0%
RBANS Attention	97.4	102.5		97.6	106.8
	21.26	14.05		6.84	8.26
	28%	6%	18%	0%	0%	25%
TMT A (raw/z score)	52.7/−1.5	50.6/−1.1	NA	52.4/−1.6	43.8/−1.2	NA
	29.52/3.16	28.75/2.10		24.31/1.38	14.75/1.83
	44%	35%		60%	50%
TMT B (raw/z score)	164.2/−3.1	157.5/−2.7	NA	132.2/−2.6	146.8/−3.0	NA
	113.89/4.39	114.04/4.43		95.93/2.09	105.16/2.19
	50%	53%		60%	75%
TMT B-A (raw/z score)	111.6/−2.6	106.9/−2.5	NA	79.8/−1.8	103.0/−2.4	NA
	96.64/4.23	95.58/4.49		74.50/2.08	111.41/3.12
	50%	41%		60%	50%

Note:—NA indicates not applicable.
a RBANS data are presented as scaled scores, which have a mean of 100 (SD, 15). Higher scores indicate better cognitive performance. The RBANS assesses 5 cognitive domains: Immediate Memory, Visuospatial/Constructional Abilities, Language, Attention, and Delayed Memory. TMT A and B scores and their contrasts (B-A, B/a) are presented as raw scores in seconds, which measure the time taken to complete the test. Lower scores indicate faster performance and better cognitive function. These raw scores are also converted into z scores, which have a mean of 0 (SD, 1). Z scores allow comparison across different tests and populations, with higher z scores indicating better performance relative to the normative sample. Sample interpretation: RBANS Immediate Memory: a scaled score of 85 would indicate performance below the average (mean of 100) for the general population, suggesting some impairment in this cognitive domain. TMT: a raw score: 35 seconds would be converted to a z score for comparison. If this z score is −1.5, it indicates that the performance is 1.5 SDs below the mean, suggesting slower processing speed compared with the normative sample.