[1]凌海平,杭春华,那世杰,等.胼胝体动静脉畸形的血管内治疗的疗效分析[J].中国临床神经外科杂志,2022,27(01):28-30+50.[doi:10.13798/j.issn.1009-153X.2022.01.010]
　LING Hai-ping,HANG Chun-hua,NA Shi-jie,et al.Clinical efficacy of endovascular treatment for patients with arteriovenous malformation of the corpus callosum: report of 6 cases and literature review[J].,2022,27(01):28-30+50.[doi:10.13798/j.issn.1009-153X.2022.01.010]
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胼胝体动静脉畸形的血管内治疗的疗效分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年01期
页码:
28-30+50
栏目:
论著
出版日期:
2022-01-15

文章信息/Info

Title:
Clinical efficacy of endovascular treatment for patients with arteriovenous malformation of the corpus callosum: report of 6 cases and literature review
文章编号:
1009-153X（2022）01-0022-03
作者:
凌海平;  杭春华;  那世杰;  庄宗;  刘涛;  戴嵬;  张庆荣
210008 南京，南京大学医学院附属鼓楼医院神经外科（凌海平、杭春华、那世杰、庄宗、刘涛、戴嵬、张庆荣）
Author(s):
LING Hai-ping;  HANG Chun-hua;  NA Shi-jie;  ZHUANG Zong;  LIU Tao;  DAI Wei;  ZHANG Qin-rong.
Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
关键词:
脑动静脉畸形; 胼胝体动静脉畸形; 血管内治疗
Keywords:
Brain arteriovenous malformation;  Corpus callosum;  Endovascular treatment
分类号:
R 743; R 815.2
DOI:
10.13798/j.issn.1009-153X.2022.01.010
文献标志码:
A
摘要:
目的探讨胼胝体动静脉畸形的临床、影像学特点及血管内治疗的临床疗效。方法回顾性分析2017年12月至2020年12月接受血管内治疗的6例胼胝体动静脉畸形的临床资料。结果6例均有脑室出血，伴蛛网膜下腔出血2例，伴胼胝体血肿3例。Spetzler-Martin分级Ⅰ级1例，Ⅱ 级3例，Ⅲ级2例。1例仅由胼周动脉供血，5例合并存在胼周动脉及大脑后动脉分支供血；6例均向大脑内静脉的深部引流，其中1例合并存在上矢状窦引流。术后即刻造影显示大部分栓塞3例，完全栓塞3例。围手术期未发生颅内出血，1例出现拔管困难而体内留管，1例因脑积水行脑室-腹腔分流，2例术后出现短时记忆下降。DSA随访71~292 d，平均（178.3±76.15）d；1例畸形复发，行立体定向放疗；1例畸形团少量残留，复查造影显示畸形团无进展；其余4例畸形团均消失。出院后半年，6例改良Rankin量表评分0~1分。结论胼胝体动静脉畸形临床少见，但出血风险较高，因此需要积极干预。由于胼胝体的特殊解剖位置，血管内治疗具有良好的适应证。术前充分评估并选择合适的栓塞方案是一种非常安全和有效的治疗手段。
Abstract:
Objective To explore the clinical and imaging characteristics of patients with arteriovenous malformation of the corpus callosum, and the clinical efficacy of endovascular therapy for these patients. Methods The clinical data of 6 patients with arteriovenous malformation of the corpus callosum who received endovascular therapy from December 2017 to December 2020 were retrospectively analyzed. Results All the patients had ventricular hemorrhage, 3 patients were complicated with corpus callosum hematoma and 2 with subarachnoid hemorrhage. Spetzler-Martin grade Ⅰ arteriovenous malformationin was found in 1 patient, grade Ⅱ in 3 and grade Ⅲ in 2. The arteriovenous malformationin was supplied only by the pericorpusal artery in 1 patient, and supplied by the branches of the pericorpusal artery and posterior cerebral artery in other 5 patients. The arteriovenous malformationin were drained to the internal cerebral vein in all the patients, of whom 1 patient had superior sagittal sinus drainage. Immediate postoperative angiography showed great partial embolization in 3 patients and complete embolization in 3. No intracranial hemorrhage occurred during the perioperative period. The catheter was remained in the patient's body due to difficult extubation. One patient underwent ventricular-abdominal shunt due to hydrocephalus. Two patients had short-term memory decline after the surgery. The DSA follow-up (range, 71~292 days; average, 178.3±76.15 days) showed a recurrence of malformation in 1 patient who received stereotactic radiotherapy due to lack of good vascular access, no progression of residual malformation in 1 patients and no malformation in 4 patients. The modified Rankin scale score of 0~1 was achieved in 6 patients 6 months after the surgery. Conclusions The patients with arteriovenous malformations of the corpus callosum are rare in clinic, but active interventions are recommended for these patients due to high risk of bleeding. The endovascular treatment has good indications for these patienrs due to the special anatomical position of the corpus callosum. Adequate preoperative evaluation and selection of appropriate embolization plan can achieve good outcomts for these patients.

参考文献/References:

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备注/Memo

备注/Memo:
通讯作者：张庆荣，E-mail：njzhangqingrong@aliyun.com
更新日期/Last Update: 2022-01-18