与板障静脉沟通的硬脑膜动静脉瘘并发颅内出血1例报道及文献复习  

Diagnosis and treatment of dural arteriovenous fistula draining to the diploic vein presenting with intracerebral hemorrhage:a case report and literature review

作　　者：李欢欢 李俊 游慧超 陈迎春 林爱龙 盛柳青 尧小龙 LI Huan-huan LI Jun;YOU Hui-chao;CHEN Ying-chun;LIN Ai-long;SHENG Liu-qing;YAO Xiao-long(Department of Neurosurgery,The Third People's Hospital of Hubei Province,Jianghan University,Wuhan 430032,China)

机构地区：[1]江汉大学附属湖北省第三人民医院神经外科,武汉430032

出　　处：《中国临床神经外科杂志》2021年第7期529-530,536,共3页Chinese Journal of Clinical Neurosurgery

基　　金：湖北省医学科研项目(WJ2019F179);湖北省联合基金立项项目(WJ2019H385)。

摘　　要：目的总结与板障静脉沟通的硬脑膜动静脉瘘(DAVF)并发颅内出血的诊治经验。方法回顾性分析血管内介入治疗的1例与板障静脉沟通的DAVF并发颅内出血的临床资料,并结合相关文献分析。结果62岁男性,左侧肢体肌力0级,头部CT示右侧额顶叶出血;DSA示右侧额顶部DAVF,由右侧脑膜中动脉额顶支供血,经板障静脉、大脑镰静脉引流并因压力增高导致皮层静脉逆流致静脉高压性脑出血;经脑膜中动脉额支注入Onyx胶闭塞瘘口,术后复查造影发现引流静脉消失;术后半年,左侧肢体肌力恢复至4级。结论与板障静脉沟通的DAVF并发颅内出血为罕见疾病,血管内治疗可达到治愈。Objective To summarize the experience in the diagnosis and treatment of the patients with dural arteriovenous fistula(DAVF)draining to the diploic vein presenting with intracerebral hemorrhage(ICH).Methods The clinical data of one patient with DAVF draining to the diploic vein presenting with ICH who received endovascular embolization were analyzed retropsectively,and the related literatures were reviewed.Results A 62-year-old man presented with left hemiparesis with muscle strength of level 0.CT on admission showed a right frontoparietal subcortical hemorrhage.DSA showed a right frontoparietal DAVF,which connected the frontoparietal branch of the right middle meningeal artery with the diploic vein and was drained into cortical veins in a retrograde manner through the falcine vein.The DAVF was successfully obliterated by embolization with Onyx glue.The postoperative DSA found that the draining veins disappeared.Six months after the operation,the muscle strength of the left limb was recovered to level 4.Conclusions Dural arteriovenous fistula draining to the diploic vein is a rare disease,which can be cured by endovascular treatment.

关 键 词：硬脑膜动静脉瘘 板障静脉 血管内治疗 ONYX胶 疗效 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]