早期显微手术治疗低级别Spetzler-Martin分级破裂出血性脑动静脉畸形的效果

目的探讨Spetzler-Martin分级（SMG）为Ⅰ～Ⅱ和部分Ⅲ级脑动静脉畸形（AVMs）出血后72 h内显微手术治疗的临床效果。方法回顾性分析15例破裂出血的SMG为Ⅰ～Ⅱ和部分Ⅲ级脑AVMs患者的临床资料，所有患者均在发病后72 h内进行显微手术治疗。结果术后随访6～24个月，平均（7.9±4.5）个月，按GOS评分标准进行预后评定。其中GOS评分5分12例，4分3例。术后复查DSA显示14例患者畸形血管团全部切除，1例有少部分残留。结论在做好充分的术前影像检查和评估的前提下，早期显微手术治疗破裂出血的SMG为Ⅰ～Ⅱ和部分Ⅲ级脑AVMs是安全有效的。

Early microsurgical treatment for hemorrhagic Spetzler-Martin low-grade cerebral arteriovenous malformation rupture: preliminary clinical experience

ObjectiveTo investigate the effect of microsurgical treatment in the first 72 hours after hemorrhage of Spetzler-Martin Grade (SMG) Ⅰ-Ⅱ and partial Grade Ⅲ cerebral arterio-venous malformations (AVMs). Methods The clinical data of 15 patients with rupture of SMG Ⅰ-Ⅱ and partial Ⅲ cerebral AVMs were retrospectively analyzed. All patients were treated with microsurgery in the first 72 hours after hemorrhage. ResultsThe patients were followed-up after surgery for 6-24 months, the mean follow-up periods was (7.9±4.5) months. The outcomes were assessed with GOS score. Twelve patients recovered well with GOS score of 5. Three patients left moderate disability with GOS score of 4. DSA re-examination in fourteen patients showed that the malformed vascular mass was completely removed, and 1 patient had some small residual. ConclusionEarly microsurgery for the SMG Ⅰ-Ⅱ and partial Ⅲ hemorrhagic AVMs is safe and effective under the condition of adequate preoperative imaging examination and evaluation. The prognosis is similar to that reported in the literature treated with staged surgery.