硬脑膜动静脉瘘的治疗

目的：探讨硬脑膜动静脉瘘的病因，分类及治疗。方法：26例均采用超选择插管栓塞，其4例同时行静脉入路静脉窦内栓塞，联合手术2例，X-刀治疗l例。结果：海绵窦区硬膜动静脉瘘者，17例瘘口完全消失，4例栓塞后瘘口有残留，结合颈动脉压迫法后2例瘘口消失。侧窦硬脑膜动静脉瘘者，瘘口完全消失3例，部分消失2例。结论：血管内栓塞治疗硬脑膜动静脉瘘是目前最安全、有效的治疗方法。联合手术或放射治疗等，可大大提高硬脑膜动静脉瘘的临床治疗愈率。

TREATMENT FOR CEREBRAL DURAL ARTERIOVENOUS FISTULAS

Objective:To explore the pathogenesis, classification and treatment of cerebral dural arteriovenous fistulas.Methods:Twenty-six cases were embolized by microcatheterization via endovascular approach.Of 26 cases, 4 cases were embolized via venous approach into venous sinus. Two cases underwent embolization combined with operation. A case underwent embolization combined with X-knife treatment.Results:In 17 of 21 cases with dural arteriovenous fistulas of the cavenous sinus, the fistulas were completely embolized angiographically. The fistulas were partly embolized in 4 of 21 cases. Uncompleted close fistulas in 4 cases were treated by pressing the affected carotid artery. The fistulas in 2 of 4 cases disappeared angiographically. Of 5 cases with cerebral dural arteriovenous fistulas of lateral sinus, the fistulas in 3 cases were completely embolized angiographically ,and the fistulas in 2 cases were partly embolized.Conclusions:Endovascular treatment of cerebral dural arteriovenous fistulas is a safe and effective method. If combined with operation and radiotherapy nowday, the treatment effect of cerebral dural arteriovenous fistulas is greatly improved clinically.