寰枕交界区硬脊膜动静脉瘘的诊断与治疗(2例报告并文献复习)

目的探讨寰枕交界区硬脊膜动静脉瘘诊断与治疗。方法采用多模式影像学方法诊断,枕下后正中入路手术治疗寰枕交界区硬脊膜动静脉瘘患者2例,并结合文献进行分析。结果本组2例寰枕交界区硬脊膜动静脉瘘患者均表现为自发性蛛网膜下腔出血,均经DSA确诊,并经枕下后正中入路成功阻断瘘口后引流静脉。结论寰枕交界区硬脊膜动静脉瘘发病率低,缺乏特征性临床表现,诊断困难;多模态影像、尤其是DSA是确诊的主要方法;开颅手术切断瘘口后引流静脉是相对安全、有较高病灶闭塞率的治疗方法。

Diagnosis and treatment of craniocervical junction spinal dural arteriovenous fistula (report of 2 cases and review of literature)

Objective To discuss the diagnosis and treatment of spinal dural arteriovenous fistula ( SDAVF ) at the craniocervical junction .Methods The clinical data of 2 patients with craniocervical junction SDAVF inspected by multimodal imaging and surgical treatment were analyzed retrospectively , and the literature was reviewed .Results Both cases manifested syndrome of spontaneous subarachnoid hemorrhage and diagnosed with DSA .The venous outflow were surgically occluded via suboccipital midline approach .Conclusions Craniocervical junction SDAVF is a type of vascular malformation with low incidence and lack of typical manifestation .Multimodel imaging , especially DSA is the main method for diagnosis of this disease .Surgical occlusion of the venous outflow using open surgery is a relatively safe and effective option for management of the disease .