CTA在脑动静脉畸形出血急诊显微外科手术治疗中的指导意义

目的 探讨多层螺旋CT血管造影(CTA)存脑动静脉畸形(AVM)出血急诊显微外科手术治疗中的指导意义. 方法 同顾性分析四川省人民医院神经外科自2004年8月至2007年10月应用CTA指导急诊显微外科手术治疗脑AVM出血的21例患者的临床资料. 结果 本组21例脑AVM患者均行血肿清除及脑AVM的显微外科手术治疗,畸形血管伞切15例.部分切除5例,1例延髓血管畸形未能切除.痊愈6例(皮层下非功能区血肿5例,小脑血管畸形1例),好转14例(皮层下功能区血肿7例,小脑血肿4例,基底节区血管畸形3例),死亡1例(延髓血管畸形).结论 CTA可完成脑AVM的诊断,指导脑AVM出血的急诊显微外科手术治疗.

The significance of computed tomographic angiography image -guided emergent mieroneurosurgical management of intracranial hemorhage of arteriovenous malformations.

Objective To evaluate the significance of computed tomographic angiography guided emergent microneurosurgical management of intracranial hemorrhage on account of arteriovenous malformations. Methods 21 cases of intracranial hemorrhage on account of the rupture of the arteriovenous malformations received computed tomographie angiography guided emergent microneurosurgical management were analyzed. Diagnosis of AVM could be identified by 3-D reformatted images obtaining from multidetector CT angiography (CTA) .Then the resections of AVM and hematoma were performed with the help of CTA. We got the results of treatment by CTA examination postoperative. Results 15 AVM nests of 21 cases after operations were cut off, 5 got partial resection, except 1 in bulbus medullae, and the clinical symptoms eliminated in 6 patients (5 cases's hematoma in subcortex indomain, 1 in cerebellum), improved in 14 patients (7 cases in subcortex domain, 4 in cerebellum, 3 in basal ganglia), 1 patient died (AVM in bulbus medullae). Conclusion CTA could be used to get the emergency diagnosis of brain AVM hemorrhage and guid the emergent microneurosurgical management.