寰枕交界区硬脊膜动静脉瘘的临床研究  

Clinical research of the spinal dural arteriovenous fistula at the atlanto-occipital junction

作　　者：王雅栋[1] 李壮志[1] 潘杰[1] Wang Yadong Li Zhuangzhi Pan Jie(Department ofNeurosurgery, Weihai Municipal Hospital, Weihai, Shandong 264200, Chin)

机构地区：[1]威海市立医院神经外科,264200

出　　处：《中国微侵袭神经外科杂志》2017年第1期24-26,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的研究寰枕交界区硬脊膜动静脉瘘(spinal dural arteriovenous fistula,SDAVF)的临床特点及诊疗措施。方法回顾性分析8例寰枕交界区SDAVF病人的临床资料,其中6例因蛛网膜下腔出血表现为急性发病;2例慢性发病,表现为感觉运动障碍。7例采用显微手术夹闭治疗,1例双侧动静脉瘘病人采用介入栓塞治疗。结果手术夹闭的7例病人术后造影显示:瘘口均消失。采用介入栓塞治疗的1例病人,仅栓塞一侧瘘口。随访8例,时间3个月~4年,急性发病病人中1例死于急性心肌梗死,余5例无复发;2例慢性发病病人肌力均得到改善。结论大部分寰枕交界区SDAVF的首发症状表现为蛛网膜下腔出血引起的急性发病,显微手术夹闭瘘口为首选方法。Objective To study the clinical features, diagnosis and treatment measures of spinal dural arteriovenous fistula（SDAVF） at the atlanto-occipital junction. Methods Clinical data of 8 patients with SDAVF at the atlanto-occipital junction were analyzed retrospectively. Acute onset was found in 6 patients because of subarachnoid hemorrhage and chronic onset in 2 who showed sensorimotor dysfunction. Microsurgical clipping was performed on 7 patients and interventional embolization on 1 with bilateral SDAVF. Results Postoperative angiography showed all fistulas disappeared in 7 patients who received clipping. One side fistula embolization was achieved in 1 patient who received embolization. Eight patients were followed up for 3 months to 4 years. One of acute onset patients died of acute myocardial infarction and the other 5 had no relapse. The muscle strength was improved in 2 patients with chronic onset. Conclusion For the majority of SDAVF patients at the atlanto-occipital junction, the first symptom is the acute onset of subarachnoid hemorrhage and microsurgical clipping is the first choice.

关 键 词：动静脉瘘 硬脊膜 寰枕交界 手术夹闭 介入栓塞 

分 类 号：R744[医药卫生—神经病学与精神病学]