血管内液体栓塞治疗硬脑膜动静脉畸形继发三叉神经痛1例  

Intravascular fluid embolization for treatment of trigeminal neuralgia secondary to dural arteriovenous mal⁃formation:a case report

作　　者：陈晨 陈光唐 徐卡娅 CHEN Chen;CHEN Guangtang;XU Kaya(Department of Neurosurgery,the Affiliated Hospital of Guizhou Medical University,No.28,Guiyi Road,Guiyang City 550004)

机构地区：[1]贵州医科大学附属医院神经外科,贵阳550004

出　　处：《中国神经精神疾病杂志》2023年第3期163-167,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：贵州省普通高等学校青年科技人才成长项目(编号:[2021]190);黔科合平台人才(编号:[2018]5779-44)。

摘　　要：血管内液体栓塞治疗硬脑膜动静脉畸形(dural arteriovenous malformation,DAVM)继发性三叉神经痛的疗效和机制尚未得到很好评估和探讨。报告1例EVAL液体栓塞剂介入栓塞桥小脑角区硬脑膜动静脉畸形继发三叉神经痛病例。患者,女,67岁,因左面部阵发性疼痛1年加重3个月入院。查体见左口角存在扳机点疼痛,左侧面部麻木,痛觉、触觉减退,余无特殊。头颅MRI示左侧桥小脑角区-左颅中窝底-左大脑表面多发异常血管畸形。诊断:左侧硬脑膜动静脉畸形。予EVAL液体栓塞剂行介入栓塞治疗实现畸形血管完全闭合。术后患者疼痛消失,随访2年未再出现三叉神经痛。该病例的治疗策略新颖,丰富了罕见病的诊疗,可为日后的临床诊治提供参考。The efficacy and mechanism of intravascular fluid embolization in the treatment of trigeminal neuralgia secondary to dural arteriovenous malformations have not been well evaluated and explored.A case of trigeminal neuralgia secondary to dural arteriovenous malformation in the cerebellopontine angle with EVAL liquid interventional embolization was reported.A 67-year-old female patient was admitted for paroxysmal left facial pain for 1 year and aggravated for 3 months.Neurological examination revealed the presence of trigger point pain in the left corner of the mouth,left facial numbness,decreased sensation of pain and touch,and no other abnormality.Brain MRI showed multiple anomalous vascular malformations in the left cerebellopontine angle-left middle cranial fossa floor-left cerebral surface.The patient was diagnosed as having a left dural arteriovenous malformation.Complete closure of the malformed vessels was achieved with EVAL liquid embolization.The patient was discharged from the hospital after the operation and no trigeminal neuralgia occurred during the follow-up.The novel treatment strategy of this case enriches the diagnosis and treatment of rare diseases and provides a reference for clinical practice.

关 键 词：硬脑膜动静脉畸形 三叉神经痛 液体栓塞 血管内治疗 桥小脑角区 

分 类 号：R743[医药卫生—神经病学与精神病学]