血管内栓塞治疗脑动静脉畸形（附23例分析）

目的：分析报告23例经血管内栓塞治疗的脑动静脉畸形。材料和方法：23例脑动静脉畸形，11例有癫痫发作史，9例蛛网膜下胜或脑内出血，5例有神经功能障碍、头痛，2例有颅内杂音。畸形团小于3cm2例，3一6cm15例，，大于6cm6例。应用Magic导管系统经股动脉行脑动静脉畸形超选择栓塞，应用NBCA或IBCA16例，线段5例，IBCA和线段2例。结果：畸形血管团栓塞90％以上9例，70—90％10例，小于50％4例，3例栓塞后行手术切除。痊愈10例，改善10例，2例有神经功能障碍，1例死亡。结论：栓塞治疗加手术切除是治疗较大的、高血流量、功能区脑动静脉畸形的较好方法。NBCA或IBCA是安全有效的栓塞材料。

AVMS Treated by Endovascular Embolization (report of 23 case)

Purpose: 23 cases of AVMS treated by endovascular embolization are reproted. Materials and methods: 23 cases , clinically 11 patients presented with seizure, 8 patients with SAH or cerebral hemorrhage, and theothers had headache or neurological deficit;two had intracranial murmur. The size of AVMS was less than 3crn in 2cases, 3-6cm in 15 cases, and more than 6 cm in 6 cases. We performed selective embolizations with IBCA orNBCA in 16 cases,thread segments in 5 cases,both IBCA and thread segments in 2 caese. Results: More than 90%AVMS nidus was obliterated in 9 cases, 70-90% in 10 cases, less than 50% in 4 caese.3 patients obtained com-plete surgical removal following the embolization. Postoperatively,the symptoms subsided in 10 cases,improved in10 cases , 1 cases died of vascular spasm. 2 cases had additional neurological deficits. Conclusion: Embolizaton com-bined with surgical resection is better way to treat the large and high-flow cerebral AVMS. NBCA/IBCA is moresafe and effective than thread segments.