栓塞后早期显微手术切除治疗脑动静脉畸形的体会

目的 探讨脑动静脉畸形的治疗方法和疗效.方法 回顾性分析13例脑动静脉畸形患者栓塞后早期显微手术切除治疗的临床资料.S-M分级：Ⅲ级3例,Ⅳ级6例,Ⅴ级4例.畸形血管团最长径2.6～ 11.8（6.8± 1.6） cm.均接受栓塞后早期（≤3 d）显微外科手术治疗,以格拉斯哥预后评分（GOS）评价疗效.结果 4例术后无症状加重;2例症状改善;7例出现相应部位的定位神经功能障碍,其中感觉障碍1例,单肢轻偏瘫2例,偏盲1例,失语1例,四肢瘫痪1例,癫痫1例,无死亡.术后GOS 5分6例,4分4例,3分2例,2分1例.术后血管造影示全切除8例,近全切除4例,部分切除1例.结论 栓塞后早期显微手术切除是脑动静脉畸形有效的治疗方法.

Early microsurgery resection after preoperative embolization in the treatment of cerebral arteriovenous malformation

Objective To investigate the treatment method and efficacy of patients with cerebral arteriovenous malformation.Methods The data of 13 cerebral arteriovenous malformation patients who treated by early microsurgery resection after preoperative embolization were retrospectively analyzed.S-M grading：Ⅲ grade 3 cases,Ⅳ grade 6 cases,Ⅴ grade 4 cases.The long diameter of malformation blood vessel was 2.6-11.8 （6.8 ± 1.6）cm.All the patients were received early （≤ 3 d） microsurgery resection after preoperative embolization.Glasgow outcome score （GOS） was picked as the criterion to evaluate the efficacy.Results No postoperative symptom increased was in 4 cases;symptom improving was in 2 cases;7 cases were appeared the corresponding parts of the localization of nerve dysfunction,among sensation disorders 1 case,light hemiplegia of unilateral 2 cases,hemianopsia 1 case,aphasia 1 case,quadriplegia 1 case,epilepsy 1 case.There was no death in the patients.Postoperative GOS 5 scores was in 6 cases,4 scores was in 4 cases,3 scores was in 2 cases,2 scores was in 1 case.The postoperative angiography showed complete resection was in 8 cases,intimate complete resection was in 4 cases,partial resection was in 1 case.Conclusion Early microsurgical resection after preoperative embolization of intracranial arteriovenous malformation is the effective treatment method.