15例脑动静脉畸形的手术治疗

Experience of 15 Cases of Surgery for Brain Arteriovenous Malformation

目的讨论手术切除治疗脑动静脉畸形（AVM）。方法回顾性分析我院自2006年5月～2009年12月间显微手术治疗的15例脑AVM。结果本组术后无死亡病例。术后1天内出现残腔血肿1例,占本组的6.7%,3天内局部脑肿胀2例,占本组的13.3%,以上3例均经加强脱水降颅压、控制血压等治疗而好转。术后患者无再次癫痫发作病例。其余12例（占本组的80.0%）恢复良好,复查DSA均显示脑动静脉畸形已全切除。本组15例随访DSA3年,均无脑动静脉畸形复发病例。结论开颅手术切除是治疗大中型脑AVM的有效手段。在治疗时,应该积极防治正常灌注压突破出血及其他并发症,通过精细的显微手术操作以获得更好的治疗效果。

Objective To discuss the surgical treatment for brain arteriovenous malformation. Methods Retrospectively review the BAVM cases treated in our center from May, 2006 to December, 2009. Results No cases were dead. 1 was with blood mass in 24 hours after surgery and 2 cases were with severe brain edema. 12 cases were well recovered and BAVMs were elimiated during DSA follow-up. Conclusions BAVM can be treated with microsurgery effectively, meanwhile, we should pay attention to the management of normal perfusion pressure breakthrough to get a better outcome.