97例脑动静脉畸形临床分析

目的:报道97例脑动静脉畸形临床分析。方法:外科手术、血管内栓塞治疗、伽玛刀(γ-刀)治疗和保守治疗。结果:手术治疗66例,优良率81.9％,病残率15.1％,手术死亡率3％。血管内栓塞治疗25例,其中栓塞100％4例,栓塞70％～95％12例,栓塞50％～70％5例,栓塞50％以下4例。3例行γ—刀治疗,3例保守治疗。有7例于手术后、4例于栓塞后行放射治疗。结论:作者认为提高脑动静脉畸形的治愈率,降低病残率及死亡率的关键在于不同部位、类型的脑动静脉畸形选择恰当的治疗方案,对各种治疗方法的适应证进行讨论。

Management of cerebral arteriovenous malformations

Clinical management of 97 cases of cerebral arteriovenous malformations ( AVM ) were reported. Method: Surgical operation, en-dovascular embolization, gamma knife radio-surgery and conservative treatment were performed for these patients. Result: 66 cases were treated surgically, excellent and good results in 81.9% were achieved in these group, the morbidity rate was 15. 1%,operative mortality was 3 % . 25 cases underwent endovascular embolization , complete occlusion of AVM nidus were obtained in 4 patients, partial occlusion of AVM nidus was presented as following: 70 % to 95 % in 12 cases;50% to 70% in 5 cases;4 cases were obliterated less than 50% of the nidus. 3 cases treated with gamma knife radiosurgery. 3 cases received conservative treatment. 7 cases after surgical treatment and 4 cases after endovascular embolization were treated with radiosurgery. Conclusion: The key point to increase the cure rate and decrease the morbidity and mortality rate is to choose the appropriate treatment for individual patients with AVM.