脑动静脉畸形的供应动脉及导出静脉与出血危险性的关系

本文通过分析５０例脑动静脉畸形（ＡＶＭ）的全脑数字减影血管造影（ＤＳＡ）资料及手术探查结果，探讨ＡＶＭ的深、浅及供血、引流血管数量与出血发生率的关系。经统计比较发现：深部较浅部ＡＶＭ出血率高；供应动脉条数多于导出静脉条数者及仅有单条导出静脉出血率最高，并与其他组有显著性差异（Ｐ＜０．０５、Ｐ＜０．０１）。因此，我们认为：在临床工作中对这些ＡＶＭ患者应给予足够的重视。     

微导管真丝线段血管内栓塞治疗脑动静脉畸形（附7例报告）

应用国产真丝线段行血管内栓塞治疗７例脑动静脉畸形（ＡＶＭ）。结果：１例术中畸形血管破裂出血死亡，１例出现半身麻木，肢体轻瘫，经治疗短期内恢复。余病例症状明显缓解或消失。此栓塞材料为永久性，较安全，效果好，并发症少。     

伽玛刀治疗青少年脑动静脉畸形83例临床分析

目的 评估伽玛刀治疗青少年脑动静脉畸形(AVM)的疗效和并发症.方法 回顾性分析使用MASEP-SRRS型头部型伽玛刀治疗的83例青少年脑AVM的资料,AVM的体积0.3～25.4 cm3,平均(2.9±1.4)cm3,边缘剂量13～23 Gy,平均(18.8±3.6)Gy,40%～65%(平均48.8%)的等剂量曲线包绕脑AVM病灶.均采用磁共振成像 数字减影血管造影(MRI DSA)联合定位.结果 随访27～72个月,用伽玛刀治疗后的脑AVM闭塞率与其体积、边缘剂量有关,大多数患者临床症状于伽玛刀治疗后消失或改善.结论 伽玛刀是治疗青少年脑AVM安全、有效、低创的新方法.     

伽玛刀治疗血管性病变后脑水肿发生率的分析

目的探讨不同的血管性疾病γ刀治疗后脑水肿的发生率。方法回顾十余年内经γ刀治疗的血管性病变358例,采用χ^2检验探讨γ刀术后不同血管性病变及不同随访时间脑水肿发生率的差异性。结果γ刀术后,动静脉畸形（AVM）组水肿阳性率为47.5%,海绵状血管瘤组为25.9%,术后水肿发生率有显著性差异（P〈0.01）。不同随访阶段水肿阳性率分别为：≤1年为47.3%,1～3年为38.0%,3～5年为37.1%,〉5年为25.0%,不同随访阶段脑水肿发生率有显著性差异（P〈0.01）。结论脑水肿是γ刀治疗后最重要的并发症之一,术后1年内水肿的发生率最高。     

联合cTnI、Mb和miR-133检测在AVM患儿诊断及预后中的作用

目的探讨联合心肌肌钙蛋白T(cTnT)、肌红蛋白(Mb)、微小核糖核酸-133(miR-133)检测在急性病毒性心肌炎(AVM)患儿诊断及预后中的作用。方法选取2017年5月至2020年4月期间郑州大学第一附属医院收治的136例AVM患儿为研究组,另选取同期健康体检的108例健康儿童为对照组。比较两组cTnI、Mb、miR-133水平。根据AVM患儿诊断后1年内预后情况将研究组分为预后不良组和预后良好组。绘制ROC曲线图,分析cTnI、Mb、miR-133联合检测对AVM的诊断价值,探究影响AVM患儿预后的独立危险因素。结果研究组cTnI、Mb表达水平高于对照组,miR-133表达水平低于对照组,差异均有统计学意义(P<0.05)。cTnI、Mb、miR-133三者联合检测对AVM诊断价值的AUC最大,为0.915(0.844～0.986)(P<0.05)。136例患儿中预后不良21例,预后良好115例。Logistic回归模型分析得:使用肾上腺素、QT间期延长、cTnI>0.09 μg/L、Mb>80 ng/mL、miR-133<3.1是影响AVM患儿预...     

脑动静脉畸形出血相关因素分析及治疗预防措施

目的:分析容易引起脑动静脉畸形出血的相关因素,探讨避免及预防出血的临床措施.方法:系统性分析71例脑动静脉畸形(arteriovenous malformation,AVM)患者的畸形血管巢的结构特点及与可引起血管压力增高有关的生活相关因素,有针对性的对易出血者实施干预措施.结果:病灶小、病变深、引流静脉少等血管的结构性特点是AVM出血的决定性因素;情绪激动、过度运动、腹压增加及饮食习惯等生活因素可引起颅内血管压力增高,导致血管破裂出血.结论:对于易出血的AVM患者采取针对性的预防干预措施可有效地降低出血率.     

A case of delayed cyst formation post brain AVM stereotactic radiosurgery for arteriovenous malformation: Case report

Arteriovenous malformations (AVMs) are a rare cause of cerebrovascular abnormality with incidence of about 1 in 100,000 people per year and point prevalence of about 0.2%. AVMs are associated with serious complications such as intracranial haemorrhage (2–4% a year, 16% and 29% at 10 and 20 years after diagnosis), seizures (10–30%), focal neurologic deficits, and headaches. The management options are surveillance, endovascular embolization, microsurgical excision and stereotactic radiosurgery (SRS).In SRS Stereotactically focused high energy beams of photons induce progressive thrombosis by fibro-intimal hyperplasia and subsequent luminal obliteration. These changes usually take one to three years known as “latency period”. Complications are reported in 8% of patients undergoing SRS, including radiographic parenchymal lesions, cranial nerve deficits, seizures, headaches, and cyst formation.Cyst formation is reported in about 1.2 % of patients undergoing SRS. While the exact mechanism of post SRS cyst formation is unclear, it is hypothesized that it might be due to damage to the blood brain barrier and increased vessel wall permeability. Delayed cyst formation is reported with latency period between 3 and 10 years after radiotherapy for treatment of cerebrovascular AVMs. However, cystic formation with longer latency periods (in one case upto 17 years) after radiotherapy for other causes such as nasopharyngeal cancers have been reported.Here we report a case of delayed cyst formation after SRS for cerebrovascular AVM with latency period of 20 years.     

Arteriovenous malformation of the pancreas associated with hepatocellular carcinoma

Summary A case of pancreatic arteriovenous malformation (AVM) with hepatocellular carcinoma is reported. The patient, a 56-year-old Japanese man, was asymptomatic. The pancreatic lesion was found incidentally during an evaluation for hepatocellular carcinoma. Celiac arteriogram demonstrated tortuous feeding arteries, a racemose intrapancreatic stain, which disappeared before the venous phase, and early portal filling.     

Role of Embolization for Cerebral Arteriovenous Malformations

Cerebral arteriovenous malformations (AVMs) are complex high-flow lesions that can result in devastating neurological injury when they hemorrhage. Embolization is a critical component in the management of many patients with cerebral AVMs. Embolization may be used as an independent curative therapy or more commonly in an adjuvant fashion prior to either micro- or radiosurgery. Although the treatment-related morbidity and mortality for AVMs—including that due to microsurgery, embolization, and radiosurgery—can be substantial, its natural history offers little solace. Fortunately, care by a multidisciplinary team experienced in the comprehensive management of AVMs can offer excellent results in most cases.