疑为高血压脑出血的近外囊部AVM的诊断和外科治疗

Arteriovenous Malformations Near the External Capsule Suspected as Hypertensive Cerebral Hemorrhage： The Diagnosis and Surgical Treatment

目的：探讨近外囊部脑动静脉畸形（AVM）所致自发性脑出血的临床特征、诊断依据、外科治疗及预后。方法：回顾性分析20例术前疑为高血压性脑出血的近外囊部AVM患者的临床资料。结果：根据Glasgow转归量表（COS）评分，恢复良好5例、中度残疾5例、重度残疾4例、植物生存4例、死亡2例。结论：外囊部AVM的正确诊断应结合临床表现、既往病史和CT等辅助检查；治疗应根据患者术前和术中实际情况采取血肿和畸形血管团合并切除或二期手术切除畸形血管团。

Objective： To investigate the clinical feature, diagnosis criteria, surgical treatment and prognosis of spontaneous intracerebral hemorrhage caused by arteriovenous malformations （AVMs） near the external capsule.Methods： To review the clinical data of 20 patients with AVMs near the external capsule. Results： According to the scores of Glasgow Outcome Scale （GOS）, five patients recovered favorably, five were moderately disabled, four were severely disabled, four were in a persistent vegetative state, and two died.Conclsions： The correct diagnosis of the AVMs near the external capsule should combine with some accessory examinations, such as clinical manifestation, previous history and CT scan. The treatment should base on the preoperative and intraoperative realities of patients using surgery to remove hematomas and tangled masses of blood vessels or a secondary operation for removing tangled masses of blood vessels.