头皮动静脉瘘五例并文献复习

目的 探讨头皮动静脉瘘的诊断方法及治疗特点.方法 回顾性分析新疆医科大学第一附属医院神经外科2015年4月至2021年8月连续收治的5例头皮动静脉瘘患者的病历资料,对其临床特点、治疗方式、预后等进行评价.采用临床症状结合影像学检查结果进行疗效评估.术后即刻行头颈部CT血管成像或DSA检查,并术后3个月经门诊或电话随访,...

Scalp arteriovenous fistula:report of five cases and literature review

Objective To discuss the diagnosis and treatment characteristics of scalp arteriovenous fistula.Methods The case data of 5 patients with scalp arteriovenous fistula admitted to the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from April 2015 to August 2021 were retrospectively analyzed,and their clinical characteristics,treatment methods,and prognosis were evaluated.Clinical symptoms and imaging results were used to evaluate the efficacy.CT angiography of the head and neck or DSA examination was performed immediately after surgery,and the patient was followed up by outpatient visit or telephone for 3 months after surgery for the postoperative symptoms and complications.The patient is considered to be completely cured if CT angiography or DSA examination immediately after surgery shows that scalp arteriovenous fistula has completely disappeared,symptoms significantly improved,and no recurrence of symptoms in outpatient or telephone follow-up.Results Five patients were characterized by progressive increase of pulsatile mass under the scalp,of which 2 cases have a clear history of trauma(1 case of occipital subcutaneous mass for 3 years after fall due to drinking,and 1 case of left frontal temporal subcutaneous mass after trauma for 4 years),1 cases of iatrogenic injury(left frontal forehead mass after intravenous drip for 13 years),and 2 cases without trauma and were found during physical examination(subscalp mass for 6 years).Chose surgical resection was performed in four patients,and chose embolization+surgical resection was performed in 1 patient.All 5 patients were completely cured after the operation,and were followed up for 1 year,4 months,2 years,6 years,and 4 years,respectively.The general condition was acceptable and there was no recurrence.Conclusions Surgical resection is the first choice for the treatment of scalp arteriovenous f istula.Careful identification of vascular structural features before surgery can help successfully treat scalp arteriovenous fistulas.