侧窦型硬脑膜动静脉瘘的诊断及治疗探讨

A study on the treatment and diag-nosis of dural arteriovenous fistulae of the lateral sinus

本文报告27例侧窦型硬脑膜动静脉瘘(DAVF),对其发病机理,血供与临床的关系以及治疗方法的选择进行了探讨.作者认为临床表现与静脉引流类型密切相关,头痛和耳后杂音是最常见的发病症状.全脑血管造影是确诊和研究本病唯一可靠的手段.对以颈外动脉及锁骨下动脉分支供血为主者,选择性血管内栓塞治疗是安全、有效、首选的治疗方法.对颈内动脉和推动脉脑膜支参入供血者,则以血管内栓塞结合手术治疗为益.

This paper reported 27 cases of dural arteriovenous fistulae (DAVF) of the lateral sinus. This study was focused on the pathogene-sis, relationship between blood supply and clinical presentation, and the choice of treatment method . The authors believe that the clinical presentations mainly depended upon the pattern of venous drainage of DAVF. The most common symptoms were headache and auricular bruit. The cerebral angiography was the most valuable means in diagnosing and investigating the DAVF. Endovascular embolization was a safe, effective method in the treatment of the fistulae fed by branches of the external carotid artery and subclavicular artery. Endovascular embolization followed by surgery was the best choice in treating the fistulae fed by meningeal branches of the internal carotid artery and vertebral arterv.