以癫痫为主要表现的大脑凸面动静脉畸形的显微手术治疗

目的探讨以癫痫为主要症状的大脑凸面动静畸形的显微外科治疗方法及效果。方法对12例合并有癫痫发作的大脑凸面动静脉畸形患者行显微手术,术中进行皮层脑电监测,确定致痫灶的位置及范围。9例在切除病灶后致痫灶消失,2例位于非功能区的予以切除,1例位于功能区的行皮层热灼。结果病灶完全切除12例,无创腔血肿,无新增脑功能障碍;随访3个月至2年,所有患者的癫痫症状消失。结论以癫痫为主要症状的大脑凸面动静畸形,显微手术能完整切除病灶。运用皮层脑电定位致痫灶,能有效地治疗癫痫,提高患者的生活质量。

Microsurgery treatment of arteriovenous malformation in cerebral convexities with epilepsy as main symptom

Objective To evaluate the treatment and therapeutic effect of arteriovenous malformation （AVM） located in the cerebral convexities with epilepsy as main symptom. Methods Twelve patients with AVM complicated with epilepsy underwent microsurgery with intraoperative electrocorticogram locating their epileptogenic zones, among which, 9 disappeared after resection of the lesions ,2 were removed since they were located in the nonfunctional areas, and 1 was performed with cortical thermocoagulation for it was located in the functional area. Results Lesions were completely removed in all 12 patients without cavity hematoma left or additional brain dysfunction. During a follow-up of 3 - 24 months, all patients＇ symptoms of epilepsy disappeared. Conclusion Microsurgery can totally remove lesions of AVM patients with epilepsy as main symptom. Epilepsy can be effectively treated with intraoperative electrocorticogram to locate epileptogenic zones, aiming at improving patients＇life quality.