Reversible cognitive impairment and parkinsonism with leukoencephalopathy due to cranial dural arteriovenous fistula

Parkinsonism and rapid cognitive impairment may have many causes, but only a few specific treatment. Cranial dural arteriovenous fistula (DAVF) represents 10-15% of intracranial malformations. Clinical manifestations depend on location venous drainage. It is common the presence pulsatile tinnitus, bruits headache or papilledema. Progressive decline an unusual presentation due to bilateral thalamic edema cortical hypertension. Endovascular surgical treatment can reverse disease symptoms.We present 74-year old man with rapidly progressive parkinsonism subsequent diagnosis (DAVF). Brain MRI revealed diffuse leukoencephalopathy probably attributable elevated pressure. He was treated partial embolization Onix left transverse sinus angioplasty. Following procedure, there substantial reduction pressure signs remarkable clinical imaging improvement, persisting at two years follow-up. This case DAVF. important suspect DAVF in cases evolving impairment, as it be reversible early