Paper - WANFANG MED ONLINE

You Position: Home > Paper

Clinical characteristics and surgical results of 2086 patients with cerebral arteriovenous malformation

( views:365, downloads:60 )

Author:: No author available

Journal Title:: CHINESE JOURNAL OF NEUROSURGERY

Issue:: 2

DOI:: 10.3760/j.issn:1001-2346.2004.02.010

Key Word:: 脑动静脉畸形;临床特征;手术风险;巨大脑动静脉畸形

Abstract：目的回顾性分析2086例脑动静脉畸形(AVM)患者和1992年后经外科手术治疗的635例患者.对这些患者的临床特征和外科手术结果加以评估.方法对1956年1月至2001年10月2086例AVM患者数据收集分析.AVM的大小范围由1～9cm.经外科手术治疗的患者按入院时间分为2组:一组为1992年至1996年,另一组由1997年至2001年.本组研究中,评估临床特征的变量包括:年龄、性别、Spetzler-Martin分级、首发症状.外科手术结果的评估是通过比较两手术组之间的手术并发症.结果脑AVM好发20～40岁,其中脑出血(43.4%),头痛(24.9%)和癫痫发作(17.3%)是首发常见的三种表现.两组间年龄分布和性别比率无差异.采用Spetzler-Martin分级系统,Ⅲ～V级患者百分率增加,Ⅰ和Ⅱ级患者百分率下降.但主要外科手术并发症的发生率(死亡,偏瘫,颅神经功能障碍和胃肠出血)无显著性差异(P=0.796).结论脑AVM是青年患者自发性颅内出血的重要原因之一.Spetzler-Martin分级对预测手术风险有帮助.显微外科手术技术使手术治疗更加安全,并成为脑AVM患者的最佳选择.在治疗巨大脑AVM时,术中栓塞后手术切除是切实可行的治疗方法.

Reference

[1]B E, Pollock,J C, Flickinger,L D, Lunsford,etc.Factors associated with successful arteriovenous malformation radiosurgery.[J].1998,42.
[2]Mohr JP,Stapf C.New concepts in adult brain arteriovenous malformations.[J].2000,13(1).
[3]S L, Ondra,H, Troupp,E D, George,etc.The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment.[J].1990,73.
[4]R T, Frizzel,W S, Fisher.Cure, morbidity, and mortality associated with embolization of brain arteriovenous malformations: a review of 1246 patients in 32 series over a 35-year period.[J].1995,37.
[5]H, OLIVECRONA,J, RIIVES.Arteriovenous aneurysms of the brain, their diagnosis and treatment.[J].1948,59(5).
[6]Guidetti Beniamino,Delitala Alberto.Intracranial arteriovenous malformations[J].1980.
[7]H. Mast,H.-C. Koennecke,J. Meisel,etc.Zur Therapie zerebraler arteriovenöser Malformationen[J].1998,69(4).
[8].Arteriovenous malformations of the brain in adults.[J].1999,340(23).
[9]Hofmeister C,Stapf C,Meisel J,etc.Demographic, morphological, and clinical characteristics of 1289 patients with brain arteriovenous malformation.[J].2000,31(6).
[10]L, Steiner,C, Lindquist,J R, Adler,etc.Clinical outcome of radiosurgery for cerebral arteriovenous malformations.[J].1992,77.
[11]Kondziolka D,Flickinger JC,Pollock BE,etc.Repeat stereotactic radiosurgery of arteriovenous malformations: factors associated with incomplete obliteration.[J].1996,38(2).
[12]W J, Michelsen.Natural history and pathophysiology of arteriovenous malformations.[J].1979,26.
[13]P M Crawford,C R West,D W Chadwick,etc.Arteriovenous malformations of the brain: natural history in unoperated patients.[J].1986,49(1).
[14]J J, Jafar,A J, Davis,A, Berenstein,etc.The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations.[J].1993,78.
[15]G A, Jessurun,D J, Kamphuis,F H, van der Zande,etc.Cerebral arteriovenous malformations in The Netherlands Antilles. High prevalence of hereditary hemorrhagic telangiectasia-related single and multiple cerebral arteriovenous malformations.[J].1993,95(3).