颅内巨大动静脉畸形的治疗及其并发症防治

Treatment and complication prevention for giant intracranial arteriovenous malformations

摘要:

目的 探讨颅内巨大动静脉畸形(arteriovenous malforation,AVM)的治疗及其防治并发症的有效方法。方法 回顾性分析2011.4~2014.4以手术切除为主,联合栓塞及伽玛刀治疗的18例巨大AVM患者的临床资料。结果 无死亡病例,有2例术前昏迷的患者,术后昏迷程度减轻。格拉斯哥预后(GOS),5分12例,4分3例,3分1例,2分2例。结论 根据患者的临床资料,制定个体化的治疗方案,重视细节,采用手术切除联合术前栓塞或/和术后放疗可以有效地降低颅内巨大AVM的手术并发症。

Abstract:

Objective To investigate the effective methods for preventing complications in the treatment of giant intracranial arteriovenous malformations (AVMs).Methods The clinical data of 18 patients who were diagnosed with giant intracranial AVMs and treated with microsurgery combined with embolization and/or Gamma Knife from April 2011 to April 2014 were analyzed retrospectively.Results There was no death reported in these patients, and two patients with preoperative coma recovered a little after operation. According to the Glasgow Outcome Scale, 12 cases scored 5, 3 cases scored 4, 1 case scored 3, and 2 cases scored 2.Conclusions Based on the clinical data, developing individualized treatment programs, paying attention to details, and using microsurgery technique combined with preoperative interventional embolization and/or postoperative radiotherapy can effectively reduce surgical complications of giant intracranial AVMs.