Galcn静脉动脉瘤样扩张——附8例报告

Vein of Galen aneurysmal dilatation-Report of 8 cases

目的:报告8例Galen静脉动脉瘤样扩张(VGAD),并对其分型、血流动力学变化所致的临床症状及治疗进行分析和讨论.方法:自1986年5月～1996年5月,在4000例脑血管造影中检出VGAD8例,进一步检查:CT3例,MRI2例,全部行全脑血管造影.行栓塞治疗6例,栓塞加X-刀治疗1例,未治1例. 栓塞材料为IBCA或NBCA.结果:症状消失2例,好转4例,无效1例.结论:已证明此种栓塞技术对于VGAD的治疗是有效的,重要的是要了解VGAD的分型和有关血流动力学变化,常需多次栓塞.

VGAD is one of the cerebral vascular malformations similar to the vein of Galen aneurysmal malformation. Which are rare seen. There were only 8 cases encountered in 4 000 cases of cerebral angiography. It accounts for 0.2% of all in-tracranial arteriovenous malformations. The presenting svmptons are usually complex, and often be misdiagnosed and improperly treated. 6 of the8 cases of VGAD were selected as the candidate for endovascular embolization, 1 case of them was managed by combination of embolization and ra-diosurgery with X-knife.The symptons of 2 cases were disappeared,4 were improved and 2 were no change. The embolic materials used were IB-CA or NBCA. To ensure a safe and effective therapy, it is essential to understand the classification and dynamic pattern about the VGAD. In some cases it may require embolization for more than one times. The key point of successful treatment is occlusion of the nidus of AVMs and the fistulus at the wall of the vein of Galen in order to diminish arteriovenous shunt and venous hypertension. The alternative of treatment of this disease is radiosurgery with y-knife or X-knife. This technique has emerged as an effective therapy for VGAD.