隐匿性脑血管畸形的诊断和微侵袭治疗

目的：报告DSA未能显示的隐匿性脑血管畸形11例，并探讨其发生机理，误诊原因和诊治原则，方法：详细分析11例病人的临床资料。结果：该病变发生机理主要是病变输入运输太细，病灶内血栓形成，出血和血肿破坏了畸形血管以及出血后血管痉挛，其被误诊原因是一些病人的临床特点，CT表现与某些胶质瘤酷似，结论：MR对隐匿性脑血管畸形的诊断有重要意义，MRA可帮助确诊。该病变不宜行血管内治疗，应以显微手术和立体定向放射治疗为主。

Diagnosis and Minimally Invasive Treatment of Angiographically Occult Cerebrovascular Malformation(AOVM)

Objectives To report 11 cases of cerebrovascular malformations which were not revealed by DSA and to explore their pathogenesis, cause of misdiagnosis and the principles of management. Methods Retrospective analysis of the clinical data of these 11 patients with AOVM was carried out. Results In the 11 patients the cerebrovascular malformations, which were not angiographically revealed, were diagnosed by MRI or the postoperative pathological examination. The main reasons for developing AVOM can be summarized as follows: the very thin arteries feeding to the foci, thrombosis in the malformed vessels, bleeding or hematoma damaging the malformed vessels and the occurrence of post-bleeding vascular spasm. In certain cases, misdiagnosis may attribute to the clinical characteristics and CT manifestation of AOVM closely similar to those with certain glioma. Conclusions The MRI is very helpful to making the diagnosis of AOVM. Microneurosurgery or stereotactic radiotherapy,rather than the endovascular therapy, is the suitable option for treatment of the patients with AOVM.