烟雾病合并颅内硬脑膜动静脉瘘1例报告并文献复习  

Moyamoya disease with intracranial dural arteriovenous fistula:a case report and literature review

作　　者：杨明林[1,2] 李智奇 廖煜君 徐锋 徐斌 YANG Ming-lin;LI Zhi-qi;LIAO Yu-jun(Department of Neurosurgery,Jiangdu People s Hospital of Yangzhou City,Yangzhou 225202,China)

机构地区：[1]江都人民医院神经外科,扬州225202 [2]复旦大学附属华山医院神经外科,国家神经疾病医学中心,上海市神经外科临床医学中心,复旦大学神经外科研究所,上海市脑功能重塑及神经再生重点实验室

出　　处：《临床神经外科杂志》2022年第4期377-380,共4页Journal of Clinical Neurosurgery

基　　金：上海市闵行区自然科学基金(2021MHZ092)。

摘　　要：目的探讨烟雾病(MMD)合并颅内硬脑膜动静脉瘘(DAVF)的病因及治疗方式。方法回顾性分析1例MMD合并颅内DAVF患者的临床资料,并对相关文献进行复习。结果本例患者为青年女性,以脑室出血为首发症状,DSA诊断为MMD合并左横窦乙状窦DAVF,行右侧颅内外血管吻合术后6个月复查示桥血管通畅,瘘口消失。结合文献复习,MMD合并DAVF分为同时伴发或继发两类,临床表现多为与MMD相关的脑缺血或脑出血。治疗常采用颅内外血管吻合术,而DAVF大多数保守治疗。结论MMD合并DAVF少见,病因不明,可能与促血管生长因子增加有关。治疗策略取决于患者临床表现和DAVF分型。Objective To explore the pathogenic mechanism and management of moyamoya disease(MMD)concurrent with intracranial dural arteriovenous fistula(DAVF).Method The clinical data of 1 patient with MMD accompanied by intracranial DAVF was analyzed retrospectively.Results The patient was a young woman with ventricular hemorrhage as the primary symptom.DSA diagnosed MMD complicated with left transverse sigmoid DAVF.Six months after the right extracranial and extracranial vascular anastomosis,the reexamination showed that the bridging vessels were unobstructed and the fistula disappeared.Combined with literature review,MMD complicated with DAVF could be divided into two types:concurrent or secondary.The clinical manifestations were mostly cerebral ischemia or cerebral hemorrhage related to MMD.Intracranial and extracranial vascular anastomosis was often used,while most DAVFs were treated conservatively.Conclusions MMD with DAVF is rare and the etiology is unknown,which may be related to the increase of angiogenic factors.The treatment strategy depends on the clinical manifestation and classification of DAVFs.

关 键 词：烟雾病 硬脑膜动静脉瘘 脑出血 

分 类 号：R743[医药卫生—神经病学与精神病学]