脑动静脉畸形的血管内栓塞治疗

目的:探讨血管内栓塞治疗脑动静脉畸形(AVM)的效果。方法:2002年5月～2004年4月,对27例AVM患者(平均年龄30.1岁)进行了血管内栓塞治疗。13例患者首发症状表现为脑出血,7例首发癫痫。颅内杂音1例。血管畸形团位于幕上者26例,位于幕下者1例。根据Spetzler-Martin分级,I级2例,Ⅱ级10例,Ⅲ级11例,Ⅳ级4例。用氰基丙烯酸酯(NBCA)栓塞了13例,用弹簧圈栓塞了5例,用NBCA及弹簧圈联合栓塞了9例。4例患者栓塞后接受了开颅手术。结果:27例患者血管畸形团栓塞后体积平均减少73.1%,3例血管畸形团经介入治疗完全消失。所有患者术后未出现新的神经功能缺失,无死亡病例。结论:血管内栓塞治疗脑动静脉畸形安全、有效性好、并发症少,可以成为治疗脑AVM的主要手段。同时栓塞Spetzler-Martin高级别AVM的深部供血动脉可以降低手术的风险,提高治愈率。

Endovascular embolization in treatment of cerebral arteriovenous malformation

Objective To evaluate the therapeutic efficacy of endovascular embolization in treatment of cerebral arteriovenous malformation.Method In the past 2 years,27 patients(meanage,30.1 years;15 males,12 females)with AVM were underwent endovascular therapy in our department.13 patients presented with intracranial hematoma,7 with epilepsy.26 of the AVMs were located sufratentorialy,and 1 was located infratentorialy.According to.Spetzler-Martin grade,there were 2 of gradeI,10 gradeⅡ,11 grade Ⅲ and 4grade Ⅳ.13 nidi were embolized with NBCA,5 with coils,9 with coils and NBCA.4 patients received operation after embolization.Results The AVM nidi shrank 73.1 % averagely in 27 patients.3 nidi was totally obliterated by embolization.No therapy related neurological deficit occurred,and no death case.Conclusion Endovascular therapy is safety and effective treatment for AVM,and less complication for patients.It plays important role in treatment of AVM.By embolized the deep feed artery,it can improve clinical outcome for patients with cerebral AVM of Spetzler-Martin grades Ⅲ～Ⅳ.