非Galen静脉的脑动静脉瘘的诊断与治疗  

Diagnosis and treatment of intracerebral arteriovenous fistulae in non-Galen veins

作　　者：姜金利[1] 李宝民[1] 李生[1] 周定标[1] 段国升[1] 

机构地区：[1]中国人民解放军总医院神经外科,北京100853

出　　处：《中国微侵袭神经外科杂志》2007年第6期257-259,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨脑内动静脉瘘的临床特点及经血管内栓塞与显微外科手术治疗脑内动静脉瘘的经验。方法6例经血管内栓塞治疗,1例栓塞后手术治疗,1例单纯采用显微外科手术处理瘘口。结果术后颅内杂音立即消失,临床症状显著改善。未发生严重并发症。随访5个月-2年病情无复发。结论血管内栓塞治疗可以直接准确地堵塞瘘口恢复正常的脑血液循环。在栓塞中挤压同侧或双侧颈总动脉可以降低瘘口的血流速度和压力,有益于栓塞成功。对不能采用血管内治疗的病例,手术夹闭瘘口是理想的选择。Objective To explore the clinical features ofintracerebral arteriovenous fistulae and the experience with endovascular embolization and microsurgical operation for intracerebral arteriovenous fistulae. Methods Six cases were embolized with detachable balloons and microcoil techniques via transfemoral approach. One was treated by open surgery after endovascular embolization. One was treated simply by microsurgery to clip the fistulae and resect the aneurysmal varix, Results Intracranial murmurs disappeared at once and clinic symptoms were obviously improved after the fistulae were blocked up. No serious complication occurred. Following up 5 months to 2 years postoperatively, no abnormality was found clinically. Conclusion Endovascular embolization can block the fistulae directly and resume the normal blood flow in the brain. Pressing ipsilateral or both common carotid arteries during the operation to aim at reducing blood flow velocity and pressure in the fistulae is an effective method for embolizing intracerebral arteriovenous fistulae. For the cases that can not be embolized via endovascular approach, microsurgical operation to clip the fistulae and resect the aneurysmal varix is another choice.

关 键 词：动静脉瘘 栓塞 治疗性 神经外科手术 

分 类 号：R651.12[医药卫生—外科学]