手术治疗外伤十年后硬脊膜动静脉瘘一例并文献复习  

Surgical treatment of spinal dural arteriovenous fistula ten years after trauma:a case report and literature review

作　　者：杨城斌 马永杰[1] 陈思畅 何川[1] 张鸿祺[1] Yang Chengbin;Ma Yongjie;Chen Sichang;He Chuan;Zhang Hongqi(Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国脑血管病杂志》2020年第9期543-545,549,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金目(81671202);北京市科学技术委员会资助项目(D161100003816001)。

摘　　要：硬脊膜动静脉瘘(SDAVF)是脊髓血管畸形中最常见的一类,但发病机制尚不明确,根据文献报道外伤可能是其发病原因之一,但国内尚无此类病例报道。首都医科大学宣武医院神经外科于2019年12月收治10年前腰骶部外伤史的SDAVF患者1例,患者为45岁男性,术前改良Aminoff&Logue量表(mALS)评分2分,脊髓血管造影明确诊断为左侧L1供血的SDAVF,行半椎板切除及引流静脉切断术,术中可见患者L1椎体骨折,术后1个月随访患者脊髓功能,mALS评分仍为2分,术后第70天患者行MRI检查见T1相脊髓显像已恢复正常,mALS评分2分。Spinal dural arteriovenous fistula(SDAVF)is the most common type of spinal vascular malformation,but the pathogenesis is still unclear.According to previous studies,trauma may be one of the causes.However,no such case has been reported in China.We presented one case of a 45-year-old patient who was admitted in the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University on December 20 th,2019 and diagnosed as SDAVF.The patient had a history of lumbosacral trauma 10 years ago.The patient had preoperative modified Aminoff&Logue scale(mALS)score of 2 points,and was diagnosed as SDAVF feed by left L 1 intercostal artery from DSA.He received hemilaminectomy at L 1 followed by drainage vein amputation.L 1 vertebral fracture was observed during the operation.The patient′s spinal cord function was followed up 1 month after surgical treatment and the mALS score was still 2 points.The patient underwent MRI 70 days after operation,and the spinal cord signal had returned to normal from T1-weighted imaging.The mALS score was still 2 points.

关 键 词：硬脊膜动静脉瘘 脊髓血管畸形 外伤 

分 类 号：R651.2[医药卫生—外科学]