重点处理静脉端治疗硬脑膜动静脉瘘

目的 探讨治疗硬脑膜动静脉瘘的有效方法。方法 20例硬脑膜动脉瘘患者，其中海绵窦区8例，横窦、乙状窦区6例，小脑幕缘3例，上矢状窦区1例，Galen静脉1例，直窦1例。行引流静脉切断术5例，静脉窦孤立术1例，经静脉途径栓塞14例。结果 临床治愈13例，症状缓解6例，加重1例。影像学检查显示：瘘口完全消失11例；部分消失9例，但血流明显缓慢。术后16例患者获随访，随访时间1个月-4年。结论 重点处理静脉端是治疗硬脑膜动静脉瘘安全有效的方法。

Treatment of cerebral dural arteriovenous fistula targetting drainage vein or sinus

Objective To investigate the efficacy of occluding the drainage veins or sinus in patients with cerebral dural arteriovenous fistulase. Methods Twenty patients with cerebral dural arteriovenous fistulae involving cavernous sinus (8), transverse sigmoid sinus (6), tentorial sinus (3), superior sagittal (1), Galen (1) and straight sinus (1), were treated by transvenous embolization (14 patients),surgical interruption of venous drainage (5) and sinus isolation (1) respectively. Results Clinical cure was obtained in 13 patients, symptoms were relieved in 6 and aggravated in one. Angiographically, complete cure was noted in 11 patients, partial disappearance of fistulas in 9. Sixteen patients were followed up for 1 48 months. Conclusion Targetting drainage vein or sinus occlusion is effective and safe in the management of patients with cerebral dural arteriovenous fistulae.