青年隐匿性脑血管畸形18例诊断与手术治疗  

Diagnosis and treatment of angiographically occult cerebrovascular malformation in 18 young patients

作　　者：梁朝辉[1] 王帅[1] 赵林[1] 田剑光[1] 刘新[1] 胡福广[1] 王立群[1] LIANG Chao-hui WANG Shuai ZHAO Lin TIAN Jian-guang LIU Xin HU Fu-guang WANG Li-qun.(Department of Neurosurgery, the Second Hospital of Hebei Medical University, Shifiazhuang 050000,Chin)

机构地区：[1]河北医科大学第二医院神经外科,石家庄050000

出　　处：《脑与神经疾病杂志》2017年第9期533-536,共4页Journal of Brain and Nervous Diseases

基　　金：河北省医学科学研究重点课题计划(20150220)

摘　　要：目的探讨青年隐匿性脑血管畸形(AOVM)患者的临床特点、诊断及治疗方法。方法分析18例青年AOVM患者临床表现,影像学资料及诊治方案,术后随访9.7±2.3个月时神经功能缺损恢复情况。结果 18例患者均以脑叶出血就诊,经全脑血管造影未发现颅内异常染色血管;其中6例患者进行磁敏感加权成像(SWI)检查;所有患者均接受血肿清除+病变切除术。术后病理报告脑血管动静脉畸形14例,海绵状血管瘤4例。术后恢复良好17例,1例患者出院时遗留一侧肢体活动不利,随访3个月恢复良好。结论针对青年脑叶出血患者,应依据头颅CT、结合数字减影血管造影(DSA)及磁共振SWI序列扫描,采取早期手术治疗,是患者预后良好的关键因素。Objective To explore clinical characteristics, diagnosis and treatment of angiographically occult cerebrovascular malformation （ AOVM ） in young patients. Method The clinical characteristics, imaging data, diagnosis and treatment strategy were analyzed in eighteen young patients with AOVM, retrospectively. The treatment effect was evaluated in 9.7 - 2.3 months following up. Results No positive sign were detected in the cerebralvascular by further digital subtraction angiograph （ DSA ） , while the patients presented sudden lobar hemorrhage. Six of eighteen patients were received magnetic resonance imaging susceptibility weighting imaging sequence scan. The nidus and hematoma were cleared out through craniotomy operation in all the patients. The postoperative pathological results showed arteriovenous malformation were fourteen cases and hemangioma were 4 ones. Seventeen patients were good and the other patient present left limb asthenia at discharge. The latter patient is good after 3 months. Conclusion The patients would be good prognosis under craniotomy operation timely base on cranial CT, DSA and magnetic resonance imaging susceptibility weighting imaging sequence scan for young patients with brain lobar hemorrhage.

关 键 词：隐匿性脑血管畸形 全脑血管造影术 磁敏感加权成像扫描 显微外科手术 

分 类 号：R743.9[医药卫生—神经病学与精神病学]