伽玛刀治疗脑血管畸形（附61例分析报告）

本文分析了伽玛刀治疗６１例脑血管畸形患者（ＡＶＭ４１例，ＡＯＶＭ２０例），经６个月、２年随访，结果１６个月以内血管巢闭塞占５４％，１８～２４个月闭塞占８０％；癫痫消失５６％（平均１．１年）；术后有１例再出血死亡（占ＡＶＭ２．４％）。作者探讨了影响畸形消失的有关因素，认为在允许范围内，剂量大，病灶消失速度快；病灶容积小，消失速度快；儿童病灶消失快。癫痫控制率偏低，若结合ＰＥＴ综合定位和处理，可望提高癫痫治愈率。对位于重要功能区或容积过大脑血管畸形，可先予其他处理，残余部分再行伽玛刀治疗。

Cerebral vascular malformation treated with gamma knife:reports of 61 cases

his paper reports 61 cases of cerehral vascular malformation were treated with gamma knife. Thefollow-up was 6 to 24 months.It was 54% during 16 months and 80% during 18-24 months the rateof vascular nidus obliteration after treatment. The epilepsy symptom was disappeared in 56% (average1.1 years),of the operation only one case died,due to hemorrhage.The relative fastors of vascular nidusobliteration were analyzed.We suggested that the bigger of irrediation dose, the faster of nidus disappear-ance:the smaller of the nidus volume,the faster of the nidus obliteration; the focus obliterated rapidly inchildren.It was harder to control the epilepsy attacks. The main reasons were that the follow-up was tooshort and the treatment of epilepsy nidus wns not complete.Now PET or the other new image methodcould be useil for localization. For the nidus located in important funetion area or the volume of focuswas too big,the other treatment method would not used.We employed gamma knife.