小脑动静脉畸形患者的临床特点和显微手术治疗(附19例报告)

Clinical features and microsurgical treatment of cerebellum arteriovenous malformations (a report of 19 cases)

目的探讨小脑动静脉畸形(AVMs)的临床特点和显微手术治疗效果。方法回顾性分析2007年8月至2008年8月收治的19例小脑AVMs患者的临床资料,所有患者均行手术切除AVMs。结果脑血管造影示,典型的小脑AVMs为特征性的蜂巢样血管团,有粗大的供血动脉和引流静脉;AVMs直径<3cm者11例,3～6cm者8例。所有病人的小脑AVMs均被手术完全切除。出院时,生活能自理14例(面瘫1例),生活需人照顾5例(遗留小脑共济运动障碍)。术后随访0.5～1年,1例面瘫患者部分恢复,5例小脑共济运动障碍患者均恢复。结论小脑AVMs有其自身特点,以中小型AVMs多见;其显微手术治疗效果良好。

Objective To analyze clinical features of cerebellum arteriovenous malformations （AVMs） and to evaluate the curative effect of microsurgery on AVMs.Methods The clinical data of 19 patients with cerebellum AVMs,who underwent microsurgery from August,2007 to August,2008,were analyzed retrospectively.Of 19 patients with cerebellum AVMs,13 underwent microsurgery through the midline approach and 6 through the other approaches.Results The cerebellum AVMs were totally removed in all the patients.The main clinical manifestations included intracranial hemorrhage,headache,consciousness disturbance,limb paralysis and cerebellar ataxia.DSA showed that the typical AVMs were a characteristic honeycomb vascular mass with big feeding arteries and draining veins.The diameters of AVMs were less than 3 cm in 11 cases,and ranged from 3 to 6 cm in 8 cases.The following up 0.5～1 year after the operation showed that of 19 patients,14 could take care of themselves and 5,who recovered from the postoperative ataxia,could basically took care of themselves.Conclusions Cerebellum AVMs were of their own characteristics.The AVMs of small or middle size are common in the cerebellum AVMs.The curative effect of the microsurgery on the cerebellum AVMs is good.