急诊显微手术治疗脑动静脉畸形破裂出血

Emergent microsurgery for cerebral arteriovenous malformation with intracranial hemorrhage

目的探讨急诊显微手术治疗脑动静脉畸形破裂出血的效果。方法回顾性分析破裂出血的24例脑动静脉畸形病人的急诊显微手术治疗。结果血肿清除+全部畸形血管切除17例,血肿清除+部分畸形血管电凝4例,单纯血肿清除3例。按GOS评分,病人恢复良好11例,轻残5例,重残4例,植物生存2例,死亡2例。结论脑动静脉畸形破裂出血急性期外科手术的正确选择是关键,争取在血肿清除同时切除畸形血管是首选方法。

Objective To explore the effect of emergent microsurgery for cerebral arteriovenous malformation （AVM） with intracranial hemorrhage. Methods Retrospective analysis was made on 24 patients with AVM accompanied with intracranial hemorrhage were emergently treated by microsurgery. Results Evacuation of hematoma and resection of AVM were performed in 17 patients, evacuation of hematoma and electrical cautery hemostasis were performed in 4 patients, unilateral evacuation of hematoma were performed in 3 patients. 2 died and 2 were in a vegetative state, 4 were severely disabled,5 were moderately disabled and 11 were recoverd well according to Glasgow outcome score （GOS）. Conclusion It was very important to select operation correctly during acute stage of AVM with intracranial hemorrhage. Evacuation of hematoma and resection of AVM was the first choice for this disease.