前颅窝底硬脑膜动静脉瘘的治疗  

Treatment of dural arteriovenous fistulas in anterior cranial fossa

作　　者：袁晖[1] 赵振伟[1] 

机构地区：[1]第四军医大学唐都医院神经外科,西安710038

出　　处：《中华神经医学杂志》2014年第1期61-64,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨前颅窝底硬脑膜动静脉瘘（DAWs）的有效治疗方案。方法收集第四军医大学唐都医院神经外科自2006年1月至2011年5月收治的13例有症状前颅窝底DAVFs患者的资料，分析其全脑血管造影（DSA）、CT、MRI影像学特点，以及所采用的治疗方式、结果和随访情况。结果6例经动脉人路插入导管用Onyx-18胶栓塞。并在接近瘘口处栓塞动静脉分流区域。7例经开颅手术阻断动静脉瘘口。13例患者均进行临床随访（6～12个月），GOS评分均为5分。所有患者复查DSA均显示DAVFs完全闭塞，未见瘘口显影。治疗后没有观察到相关后遗症。结论前颅窝底DAVFs开颅手术效果好，如有硬脑膜中动脉前支供血的病变，经动脉入路栓塞前颅窝底DAVFS的可行性亦较高。Objective To analyze the image, treatment methods and results of 13 patients with dural arteriovenous fistula （DAVF） in the anterior cranial fossa to investigate the treatment strategy. Methods Radiographic examinations （digital subtraction angiography, CT and MRI）, surgical methods, and follow-up data of 13 symptomatic patients with DAVFs in the anterior cranial fossa, admitted to our hospital from January 2006 to May 2011, were retrospectively analyzed. Results Catheterization was performed via transarterial approach in six patients; embolization was performed using a liquid embolic system （Onyx-18, MTI）. Craniotomy to block the arteriovenous fistula was performed in 7 patients. All patients were followed up for 6-12 months; Glasgow outcome scale （GOS） scores were 5 in all cases. Angiographic follow-up showed complete occlusion of the DAVFs in all patients, without observed fistula. No post-treatment complications were observed. Conclusion Direct surgical management can get good result for DAVFs of anterior cranial fossa; for lesions fed by anterior branch of middle meningeal artery, transarterial embolization of anterior cranial fossa DAVFs is feasible.

关 键 词：硬脑膜动静脉瘘 前颅窝底 治疗 

分 类 号：R743.4[医药卫生—神经病学与精神病学]