脑动静脉畸形的显微手术体会

目的 探讨脑动静脉畸形(AVM)显微手术治疗的经验和技巧.方法 回顾性分析了近8年采用显微手术治疗的44例AVM患者的临床资料.结果 所有病人均进行了畸形血管团显微切除手术(合并有血肿的同时行血肿清除术),其中42例为全切除,2例为次全切除.术后病人都良好生存,其中1例病人术后早期出现阻塞性脑充血.结论 采用显微手术切除畸形血管团是根治AVM、预防出血的可靠方法,详尽的影像放射学资料是术前设计手术方案所必备的,熟练的显微手术操作技巧是手术成功的关键.

Microsurgery for cerebral arteriovenous malformations (report of 44 cases)

Objective To summarize the experience in treating cerebral arteriovenous malformations (AVM) and explore the skills of microsurgery for AVM. Methods The clinical data of 44 patients with cerebral AVM who underwent microsurgery from September, 2003 to May, 2011 were analyzed retrospectively. Of 44 patients (mean age, 30.4 years), 28 were male and 16 female. There were intracranial hematomas and/or subarachnoid hemorrhage in 34 patients. The definite diagnosis as AVM was made by DSA or surgery. Results Of 44 patients with AVM, 42 received totally removal of AVM lesions and 2 subtotally. There was the occlusive hyperaemia early after the surgery which disappeared via the conservative treatment 21 days after the surgery. Conclusions Microsurgical resection should be the first choice for the treatment of AVM. The detail preoperative neuroradiological information is necessary to the microsurgery design and skillful microsurgical techniques were the key to successful treatment in the patients with AVM.