脑动静脉畸形破裂出血的急诊显微手术治疗

Emergency Microsurgery for Cerebral Arteriovenous Malformations with Intracranial Hemorrhage

目的探讨急诊显微外科手术治疗脑动静脉畸形(AVM)破裂出血的效果。方法对26例破裂出血的脑AVM病人实施急诊显微手术治疗,清除血肿,同时切除畸形。结果手术完全切除病灶22例,占85%;次全切除4例,占15%。按GOS评分,病人恢复良好16例,轻残5例,重残3例,植物生存1例,死亡1例。结论急诊显微外科手术能够提高脑AVM破裂出血的治愈率,降低伤残率和手术风险。

Objective To explore the effect of emergent microsurgery on cerebral arteriovenous malformations （AVMs） with intracranial hemorrhage. Methods From March 2000 to February 2006,26 patients with AVM accompanied with intracranial hemorrhage were emergently treated by microsurgery. The elimination of hematomas and removal of AVM were simultaneously performed. Results The lesions were totally removed in 22 patients （85%） and subtotally in 4. One died and 1 was in a vegetative state, 3 were severely disabled, 5 were moderately disabled and 16 were recovered well according to Glasgow outcome score （GOS）. Conclusion The emergent microsurgery is an effective method to treat AVMs with intracranial hemorrhage because it can heighten cured rate and decrease disability rate in the patients with cerebral AVM accompanied with intracranial hemorrhage.