隐匿性脑血管畸形的诊断治疗体会

Diagnosis and treatment experience of occult cerebrovascular malformation

目的 总结隐匿性脑血管畸形的诊断和治疗体会,以供临床工作参考.方法 将本院2009年8月～2012年7月收治的18例隐匿性脑血管畸形患者纳入本研究,经磁敏感加权成像（SWI）技术确诊后采用显微外科手术治疗.回顾性分析患者的临床资料,总结诊断和治疗体会.结果 所有患者中海绵状血管瘤15例、毛细血管扩张症1例、发育性静脉畸形2例.病变位于额叶10例,顶叶5例,颞叶2例,小脑半球1例.经显微外科手术治疗后随访12个月,痊愈13例,轻度偏瘫5例,未发生癫痫发作和再次出血.住院时间为（21.74±4.27）d.结论 SWI技术在隐匿性脑血管畸形的临床诊断中具有重要的价值,经显微外科手术治疗后患者预后良好,在今后的临床诊断和治疗工作中应予以重视.

Objective To summarize the diagnosis and treatment experience of occult cerebrovascular malformation for reference in clinical practice. Methods Eighteen cases of occult cerebrovascular malformation hospitalized during Au- gust 2009 to July 2012 in our hospital were enrolled in this study.The patients were diagnosed by susceptibility weight- ed imaging （SWI） and then were treated by microsurgery.The clinical data of these patients were retrospectively ana- lyzed and the diagnosis and treatment experience was summarized. Results Of the 18 cases,15 cases were cavernous hemangioma,1 case was telangiectasia,and the other 2 cases were developmental venous malformation.The lesions were located in the frontal lobe in 10 cases,parietal lobe in 5 cases,temporal lobe in 2 cases,and cerebellar hemispheres in one case.The patients were followed up for 12 months after microsurgery and the follow-up results showed recovery in 13 cases and mild hemiparalysis in 5 cases.No epileptic seizure or recurrent hemorrhage was observed.The length of stay was （21.74＋4.27） d. Conclusion SWI has great value in clinical diagnosis of occult cerebrovascular malformation. Patients diagnosed by SWI show favorable prognosis after microsurgery.Therefore,more importance should be attached to SWI in the future clinical diagnosis and treatment practice.