Migraine and Intracranial Vascular Malformations

SYNOPSIS
The relationships between migraine and A-V Malformations is a subject of controversy and the arguments are mainly based on case reports and retrospective data. To clarify this subject a structured inquiry and classification of headaches in large samples of patients with intracranial vascular malformations (IVM) is essential. The authors studied the prevalence of headaches in 51 patients with IVM admitted to our Department, between 1984 and 1992. The methods used were a review of medical records followed by a self-administered headache questionnaire and clinical interview using the IHS criteria for the diagnostic classification of headaches. The relative frequency of the different types of headaches was calculated and compared with the general population data. A correlative study of the headache characteristics with the type and location of the IVM was made. A high prevalence (47%) of migraine type headaches and a strong positive correlation (88.8%) between the site of AVM and side of the pain was found. This is highly suggestive but not conclusive of a pathophysiologic relationship between these entities. The conclusion drawn is that a prospective study of headaches by questionnaire or semi-structured clinical interview in patients with IVM is essential to discover the effective prevalence and characteristics of headaches associated with IVM and their relationships.     

156例脑血管畸形的临床病理分析

脑血管畸形并发出血是导致青年人脑卒中最主要的原因之一。本文通过１５６例活检诊断为脑血管畸形者的临床病理分析，得出其平均发病年龄３２．７岁，男女之比１．７：１，好发部位为大脑中动脉供血区，最常见的组织学类型是动脉脉畸形，并简要讨论了其诊断及其与及肿瘤的关系。     

335例先天性血管畸形诊断治疗体会

目的：探讨先天性血管畸形（血管瘤）诊断与治疗的方法。方法：分析３３５例血管瘤的临床表现、体格检查、辅助检查和造影、ＣＴ、ＭＲＩ等及治疗方法如手术、手术结合铜针、铜针、硬化剂、术中缝扎和电凝的应用。结果：本组手术切除１６１例,部分切除８１例,硬化剂注射３２例,铜针治疗１８例,需植皮４７例,皮瓣修复１９例,Ⅰ期治疗２８４例,分期治疗３５例,达到“治愈”或“缓解”的３１０例。效果差者多为蔓状血管瘤,最终     

经阴道三维超声宫腔造影诊断先天性子宫畸形

目的 评价经阴道三维超声宫腔造影对先天性子宫畸形的诊断价值。方法 应用经阴道三维超声对35例疑似子宫畸形患者进行官腔内生理盐水灌注后扫查，并与宫腔镜和腹腔镜检查结果对照。结果 6例诊断为完全纵隔子宫，19例诊断为不完全纵隔子宫，10例诊断为双角子宫。经阴道三维超声宫腔造影的准确度为100％。结论 经阴道三维超声宫腔造影方法简便、易行，准确度高，是诊断先天性子宫畸形的可行方法。     

Urinary bladder cavernous hemangioma in a 3‐year‐old: A rare case report

Cavernous hemangioma (CH) of urinary bladder occurs relatively infrequently, accounting for 0.6% of all bladder tumors. This tumor may occur sporadically or coexist with other benign and malignant vascular lesions. In this report, we present a rare case of CH in a 3‐year‐old Ugandan girl. A 3‐year‐old girl was referred to Mbarara Regional Referral Hospital (MRRH) for urological evaluation following a 3‐year history of intravaginal swelling, dysuria, and heavy hematuria resulting in anemia. Imaging was consistent with polypoid bladder mass arising from the bladder trigone. Embryonal rhabdomyosarcoma was suspected based on clinical eyeballing. She was worked up for chemotherapy and received 26 cycles of vincristine sulfate, actinomycin‐d, and cyclophosphamide (VAC). Biopsy and fulguration were performed after optimizing the patient. Histopathology confirmed CH. The surgery was uneventful and resulted in complete cure. CH should be considered in the differential diagnosis of childhood genitourinary masses. It is a rare entity in the real‐life clinical practice and therefore can be overlooked. Excision biopsy and histology should be performed before initiating the patients to chemotherapy. CH is very insensitive to chemotherapy and therefore surgery maybe adequate in resource‐limited settings.     

基质金属蛋白酶-9、磷酸化的促血管生成素受体-2在肌肉血管瘤中的表达及意义

目的:检测肌肉血管瘤血管畸形组织中基质金属蛋白酶-9(MMP-9)及磷酸化的促血管生成素受体(Tie2)的表达,并探讨其意义。方法:收集肌肉血管瘤标本39例、正常颅面部皮下组织标本10例,采用ABC免疫组化染色检测MMP-9、磷酸化的Tie2的表达。结果:MMP-9、磷酸化的Tie2在肌肉血管瘤组织中的阳性表达远高于在正常皮下组织中的表达,差异具有统计学意义(P<0.01);其表达的强度在不同病程、瘤体大小、部位及浸润程度的病例中无明显差异(P>0.05)。结论:MMP-9、磷酸化的Tie2可能参与肌肉血管瘤发生、发展。     

原发性高血压患者血管内皮舒张功能的超声研究

目的及方法 :本文应用血管超声技术对 2 8名原发性高血压患者 ( 期 17例 , 期 11例 )和 13名正常人前臂动脉血管内皮依赖性舒张功能进行了定量研究。结果 :高血压 组及 组患者反应性充血后血流介导的血管扩张 (FMD)均较正常人明显下降 (P<0 .0 5 ,P<0 .0 1)。高血压 组与 组患者充血反应 (RH)均较正常人明显减少 (P<0 .0 5 ) ,而平滑肌介导的血管扩张功能 (GNT- MD)在三组中无差异。正常人给予左旋精氨酸 (L - Arg)后 ,FMD及 RH增加 ,与用药前相比有明显差异 (P<0 .0 5 ) ,平滑肌介导的血管扩张功能 (GNT- MD)在用药前后无差异 ,而两组高血压患者给予 L - Arg后 ,FMD,RH及 GNT- MD在用药前后均无差异。结论 :无创性血管超声检查血管内皮功能的方法在临床应用中是可行的     

长脉冲1 064 nm Nd：YAG激光治疗婴幼儿皮肤血管瘤60例疗效研究

目的:观察长脉冲1064 nm Nd:YAG激光治疗婴幼儿皮肤血管瘤的临床疗效。方法:随机抽取我院2013年12月~2014年11月收治的60例皮肤血管瘤患儿作为研究对象,均采用长脉冲1064 nm Nd:YAG激光对60例患儿实施治疗,观察60患儿的临床治疗效果和不良反应情况。结果:60例患儿的临床治疗总有效率为96.7%。鲜红斑痣、单纯性血管瘤、混合型血管瘤患儿的临床治疗总有效率分别为94.4%、100.0%和90.0%;60例患儿的不良反应发生率为5.0%。结论:采用长脉冲1064 nm Nd:YAG激光对皮肤血管瘤患儿实施治疗,不良反应少,疗效确切。     

长脉冲1064nm Nd:YAG激光治疗婴幼儿皮肤血管瘤60例疗效研究

目的：观察长脉冲1064nm Nd:YAG激光治疗婴幼儿皮肤血管瘤的临床疗效。方法：随机抽取我院2013年12月至2014年11月收治的60例皮肤血管瘤患儿作为研究对象,均采用长脉冲1064nm Nd:YAG激光对60例患儿实施治疗,观察60患儿的临床治疗效果和不良反应情况。结果：60例患儿的临床治疗总有效率为96.7%,其中鲜红斑痣、草莓状血管瘤、混合性血管瘤患儿的临床治疗总有效率分别为92.3%、100.0%和93.3%,三者比较无明显差异（P>0.05）60例患儿的不良反应发生率为5.0%。结论：采用长脉冲1064nm Nd:YAG激光对皮肤血管瘤患儿实施治疗,不良反应少,疗效确切。     

彩色多普勒血流显像在下肢血管旁路术前后的应用

目的 探讨彩色多普勒血流显像（CDFI）在下肢血管旁路术前后的应用价值。方法 对9例患者术前予CDFI和／或数字减影血管造影（DSA）检查,术后进行了超声随访。结果 9例髌股动脉、股动脉闭塞,CDFI诊断正确,闭塞远心端定位准确,而2例髂股动脉闭塞近心端显示不清。7例血管移植物血流通畅,2例PTFE移植物急性血栓形成。1例小腿肌层血肿。结论 CDFI是下肢血管旁路术术前评价和术后随访有价值的方法。     

肝脏海绵状血管瘤的诊断与外科治疗

目的为探讨肝脏海绵状血管瘤 (LHG)的诊断和治疗特点。方法回顾性分析了 5 6例经手术治疗的LHG病例资料 ,对其诊断和治疗的有关问题进行了讨论。结果 5 6例LHG有右上腹疼痛者占 6 4.3 % ,有肝大者占 39.3 % ;B超诊断符合率 87.5 % ,CT诊断符合率 96 .3 %。根据病例具体情况 ,对 5 6例分别行肝叶切除、半肝切除、瘤体捆扎、肝血管瘤剜除、肝动脉结扎或(和 )栓塞术等手术。结论LHG临床表现不典型 ,诊断主要依靠B超及CT检查 ,其他辅助检查如肝动脉造影等有助于肝癌的鉴别诊断。其治疗仍以手术为主 ,术式选择应根据肿瘤大小 ,部位及病人情况而论 ,对直径 <5cm的LHG可不手术切除 ,但要定期复查。     

高血压患者血管内皮功能紊乱的超声研究

目的　应用高频超声观察高血压患者内皮功能改变。方法　对高血压Ⅰ期及高血压Ⅱ期患者 (各 3 0例 )分别检测肱动脉对反应性充血 (诱发内皮细胞依赖性血管扩张EDD)和舌下含服硝酸甘油 (诱发内皮细胞非依赖性血管扩张EI DD)的反应 ,并与 3 0例对照组比较。结果　高血压Ⅰ、Ⅱ期组EDD值均较正常人明显下降 (P <0 .0 1) ,EIDD值三组间无差异 (P >0 .0 5 )。结论　高血压患者存在血管内皮功能障碍 ,以超声测定肱动脉内皮细胞依赖性血管扩张反映内皮功能是一种准确的方法     

实时双平面经胸超声心动图检出右心室海绵状血管瘤1例

患者女,71岁,无诱因胸闷气喘半年余,活动后加重,偶感心前区疼痛,可自行好转;既往高血压病史.查体于胸骨右缘第3肋间闻及心脏杂音.实时双平面经胸超声心动图(transthorcic echocardiography,TTE)于右心室侧壁见45 mm×30 mm椭圆形中等回声团块(图1A),形态规则,边界清晰,随心脏收缩...     

血管超声对高血压患者脉压与动脉硬化的相关性

目的通过血管超声学检测探讨高血压患者动脉硬化和脉压的相关性。方法102例高血压患者,根据脉压是否≥60mmHg分为A(42例)、B(60例)两组,分别检测患者颈动脉、股动脉和肱动脉内中膜厚度,测定肱动脉内皮功能。结果A组有31例(73.8%)出现大动脉内中膜厚度异常,B组有19例(31.7%)(χ2=15.782,P<0.001);A组两支或以上血管病变22例(52%),B组有4例(6.7%)(χ2=18.426,P<0.001);两组间肱动脉基础血管内径、血流速度无显著性差异(t=1.02;P>0.05)。反应性充血内径变化量(t=4.78;P<0.05)和反应性充血血流速度变化量(t=5.57;P<0.05)均存在显著差异。结论脉压的升高与动脉硬化进展具有显著性关性。     

Cavernous hemangioma of the breast: mammographic and sonographic findings and follow-up in a patient receiving hormone-replacement therapy

We report the case of a 78-year-old woman who had been receiving hormone-replacement therapy (HRT) for 6 years and had a 4-month history of a painless nodule in the 9 o'clock position in her right breast. Mammography performed 4 years previously had shown a 4-mm bilobed, ovoid, well-defined nodule in that location; mammography performed 1 year previously had shown that the nodule had increased to 6 mm. We performed mammographic and sonographic examinations, which revealed a 10-mm ovoid nodule in the same 9 o'clock position in the right breast. The imaging findings appeared to indicate benignity, but because of the increasing size of the nodule, we undertook an ultrasound-guided large-core needle biopsy. The histopathologic diagnosis was typical cavernous hemangioma. It was not excised, but HRT was discontinued. Follow-up mammography and sonography 8 months later showed that the nodule had decreased to 6 mm. We believe that the HRT played a contributory role in the increasing size of this patient's cavernous hemangioma. The use of ultrasound-guided large-core needle biopsy is reliable enough to ascertain the benignity of such masses and can thus avoid, if it is clinically appropriate, the need for their surgical removal.