• World Neurosurg · Aug 2020

    Case Reports

    Amateur Endurance Athletes: at higher risk of suffering dural arteriovenous fistulas? Report of 3 cases.

    • Ana Rodríguez-Hernández, Ramon Torné, Blanco Ibáñez de Opacua Alberto A Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain., Ferran Brugada-Bellsolà, Sebastián Remollo, Carlos J Domínguez, and Jordi M Rimbau.
    • Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain. Electronic address: ana.neurosurgery@hotmail.com.
    • World Neurosurg. 2020 Aug 1; 140: 32-36.

    BackgroundThe present study aims to draw attention to the fact that endurance sport could be a risk factor for dural arteriovenous fistula (DAVF) development. DAVFs have been correlated with acquired dural venous sinus anomalies owing to trauma, infection, neoplasia, or other classic risk thrombogenic factors. Here we report 3 cases of intracranial DAVF in young healthy patients who had no known thrombogenic risk factors other than amateur intensive sports practice.Case DescriptionThree young healthy individuals not fitting into the classical clinical picture of a DAVF patient presented to our institution. One was a 40-year-old man with an acute subdural hematoma secondary to an ethmoidal DAVF. Another 41-year-old man presented with a cerebellar hematoma due to a tentorial DAVF. A third 41-year-old man presented with numbness of his right arm in relationship to a superior sagittal sinus DAVF. None of them had a relevant medical history. All the usual thrombogenic risk factors for DAVF development were ruled out. Interestingly, the 3 patients had outstanding training and practice routines for endurance sports.ConclusionsDehydration, microfractures, muscular contractures, low heart rate, long distance travel, and high altitudes are all well documented thrombogenic risk factors affecting endurance sports amateur athletes and might represent a plausible mechanism for the development of DAVF. Despite its limitations, to our knowledge, this is the first work suggesting a possible link between such sport practice and DAVF development. Further prospective research from larger dedicated vascular centers might shed further light on this hypothetic but intriguing link.Copyright © 2020 Elsevier Inc. All rights reserved.

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