脑室系统动静脉畸形的诊断与治疗

目的 深入认识脑室系统的动静脉畸形,以期提高诊疗水平.方法 结合国外文献回顾性总结10例脑室系统的动静脉畸形的临床表现、影像学检查、诊断及治疗.结果 头痛是最常见的临床表现,3例在CT及MRl上小具有典型的动静脉畸形表现,DSA的阳性率为66.7%,10例均接受手术,8例全切,2例部分切除,均经病理证实为动静脉畸形.1例术后死亡,1例术后加γ-刀治疗,1例因仍有脑积水而行V-P分流术,随访1-1.5年,9例均无明显神经功能废损.结论 脑室系统动静脉畸形发病率低,出血及脑积水多见,手术切除是脑室系统动静脉畸形的最佳选择,而对于无法切除者,手术的目的 是解决脑积水.

The diagnosis and treatment of ventricular arteriovenous malformation

Objective To recognize ventricular agefiovenous mafformation(AVM)in detail,so as to improve its diagnostic Ievel and attain better prognosis.Methods A retrospective review of 10 cases of ventricular afleriovenous malfbrmations(including their clinical manifestations,imaging examinations,diagnostic modalities and surgical outcomes)and literature review were performed.Results Headache was the most common manifestation.There was no characteristic manifestation of AVM in three cases.The positive incidence of DSA Was 66.7%.The 10 cases were all resorted to surgery.and the lesions were total resected in 8 cases and partial resected in 2 cases.The Jesions were Confirmed to be AVMs by pathology.One case died,and gama-knife was performed in one partial resected case.One case was resorted to V-P shunt to resolve none-obstructive hydrocephalus.During the follow-up duration(1-1.5 years).no significant neurological deficient Was found.Conclusion The incidence of ventricular AVM iS very low,while bleeding and hydrocephalus are very common.Surgical removal of the lesion iS the best choice for ventficular AVM.But.for unreseetable case.the aim of operation is to resolve hydrocephalus.