小脑上动脉供血的动静脉畸形的临床特点与手术治疗

Clinical features and microsurgical treatment of arteriovenous malformations into which superior cerebellar arteries fed

目的研究小脑上动脉(SCA)供血的动静脉畸形(AVMs)的临床特点、手术入路和治疗效果。方法 SCA供血的8例AVMs患者平均年龄20.75岁,主要表现为颅内出血、头痛、癫痫、肢体瘫痪、共济失调等。AVMs直径0.5～2.5cm5例,3～5cm3例,均经幕下小脑上入路切除AVMs。结果 8例AVMs均全切除,出院时生活自理5例,基本自理3例(共济失调)。术后随访0.5～1年,共济运动障碍者均恢复。结论 SCA供血的AVMs有其自身特点,AVMs主要累及小脑上蚓部和小脑半球上部,以中小型多见,适宜通过幕下小脑上入路进行手术治疗。

[Abstract] Objectives To analyze clinical and imaging features of the arteriovenous malformations （AVMs） into which the superior cerebellar arteries （SCA） fed and to evaluate the approach of microsurgery for AVMs and its curative effect on AVMs. Methods The clinical data of 8 patients with AVMs into which SCA fed, who underwent microsurgery through occipital transtentorial approach for AVMs, were analyzed retrospectively. The average age of patients was 20.75 years. The main clinical manifestations included intracranial hemorrhage, headache, epilepsy, limb paralysis and cerebellar ataxia. Results AVMs were totally removed in all the patients. The diameters of AVMs ranged from 0.5 to 2.5 em in 5 patients, and from 3 to 5 cm in 3 patients. The following-up from half to one year showed that 5 patients could completely take care of their own life and 3 partially. The eerebellar ataxia disappeared in the patients with ataxia within 1 year after the microsurgery. Conclusions AVMs into which SCA fed have their own characteristics which include that most the AVMs locate in the cerebellar vermis and superior cerebellar hemisphere near the axial line and small or middle size AVMs are common. AVMs should be removed by the microsurgery through the occipital transtentorial approach.