颅内隐匿性血管畸形出血的手术治疗

Surgical Treatment of Intracranial Angiographically Occult Vascular Malformations Hemorrhage:40 Cases Report

目的总结颅内隐匿性血管畸形(AOVM)出血的手术治疗效果。方法对40例显微手术切除病灶的隐匿性脑血管畸形出血患者进行回顾性分析。结果40例均顺利切除病灶,无手术死亡。对36例平均随访28个月,复查CT和/或MRI无病灶残留,术后并发症大多有所恢复;1例48个月后原位再出血;1例44个月后发现新生病灶。结论手术是治疗颅内AOVM出血的安全有效方法,为防止残留和新生病灶出血,术后需要长期随访观察。

Objective To review the surgical technique and outcome of intraeranial angiographieally occult vascular malformations （AOVM） hemorrhage. Methods 40 patients with spontaneous intracranial hemorrhage episodes and accepted microsurgery were analyzed retrospectively. Results All AOVMs were successfully resected. No operative death occurred, 36 patients were followed up for mean 28 months. CT and/or MRI revealed no residual lesions, Most neurological complications improved postoperatively. 1 case demonstrated rebleeding in surgical site 48 months after operation, Another case, a follow-up MRI scan revealed a contralateral denovo lesion 44 months after operation. Conclusion A current neurosurgieal procedure is a satisfactory method to prevents AOVMs rebleeding. Long-term follow-up evaluation is necessary despite the lesion has been totally resected.