脑动静脉畸形出血危险因素的研究

Studies on hemorrhagic risk factors of cerebral arteriovenous malformations.

目的探讨脑动静脉畸形（ＡＶＭ）出血的危险因素。方法统计２８４例ＡＶＭ的数字减影脑血管造影所示病灶的解剖部位和大小、引流静脉的数目和类型，测定１８例供血动脉平均压力和以经颅多普勒超声检查７４例血流动力学参数，并分出血组和非出血组进行比较。结果小病灶、深部病变、单支静脉引流和深静脉引流者出血发生率显著增高，出血组病灶供血动脉平均压力高于非出血组，而血流速度则低于非出血组。结论脑ＡＶＭ出血与病变的大小、部位、引流静脉的类型和数目。

Objective To study the Hemorrhagic risk factors of cerebral arteriovenous malformations (AVMs) Methods 284 patients with AVMs were studied in size and location of the AVMs, the number and type of draining veins by digital subtracted angiography (DSA).Feeding mean arterial pressure (FMAP) were determined in 18 patients. Hemodynamic parameter was measured by transcranial Doppler (TCD) in 74 patients and compared hemodynamic parameter between hemorrhagics and nohemorrhagics group. Results The result showed that smaller nidus size, deep nidus of location and the presence of deep venous and single venous drainage are factors that may induce hemorrhage from AVM. TCD indices related to nidal size related to nidal size and propensity for hemorrhage, higher FMAP is an important factor in the pathophysiology of hemorrhage from AVM. Conclusions Hemorrhage of cerebral arteriovenous malformation was related to size, location, venous drainage type and number, feeding artery presence and blood flow velocities of nidus. 