隐匿性脑血管畸形的诊断与治疗(附15例报告)

目的探讨隐匿性脑血管畸形(AOCVM)的临床表现、诊断及治疗。方法回顾性分析15例AOCVM的临床及影像学资料,12例予以骨瓣复位,3例行去骨瓣。结果 AOCVM患者无特异性临床表现,本组病人均以脑出血或癫痫发作发病,表现为相应的症状和体征。CT显示为不规则混杂密度影,或在血肿周围出现环状、点状增强影。DSA检查没有发现明显的血管畸形征象或者为无血管区占位,类似脑出血。随访3个月～5年,痊愈10例,轻度偏瘫5例,所有患者均无癫痫发作和再出血。结论临床及影像学表现具有上述特点者,应考虑AOCVM,病理检查和显微外科手术是最佳确诊与治疗方法。

Diagnosis and treatment of angiographically occult cerebrovascular malformation (report of 15 cases)

Objective To discuss the clinical features,diagnosis and treatment of angiographically occult cerebrovascularm alformation（AOCVM）.Methods The clinical data of 15 patients with AOCVM who underwent microsurgery were analyzedr etrospectively.The literature related to AOCVM were reviewed.Results There were no distinctive clinical manifestations in the patientsw ith AOCVM,in whom there were clinical manfestations induced by the cerebral hemorrahage and epilepsy when they come down withA OCVM.The preoperative CT showed an irregular mass of mixed intensity,or circular and stripe-like contrast enhancement around theh ematomas.DSA showed no obvious cerebrovascalar malformation.The postoperative CT showed that the foci disappeared in all thep atients.The following up from 3 months to 5 years showed that 10 were cured and 5 had mild hemiplegia.Conclusions The definited iagnosis of AOCVM is dependent on microsurgery and pathological examination.The curatie effect of microsurgery on AOCVM is goodi n the majority of the patients.