颅内硬脑膜动静脉瘘引起严重脊髓症状(3例报告)

Severe Myelopathy Caused by Intracranial Dural Fistulas with Spinal Cord Venous Drainage

目的 :结合 3例硬脑膜动静脉瘘 (IDAVF)伴脊髓表面引流的影像学、临床表现、病程特点 ,探讨引起脊髓症状的原因。方法 :分析 3例IDAVF伴脊髓表面引流的影像学特点、临床表现、病程发展 ,结合文献加以分析和讨论。结果 :临床症状主要表现为颅内症状者 1例 ,脊髓症状者 2例。结论 :IDAVF伴脊髓表面引流的临床表现与脊髓根静脉的引流出路有关。硬脑膜动静脉瘘伴脊髓症状的诊断较困难 ,特别是仅有脊髓症状者。年轻人中慢性脊髓病变 。

Aim:To find the causes of intracranial dural arteriovenous fistulas(IDAVF) with spinal cord venous drainage in 3 cases combining with the clinical features,radiological findings and course.Methods:The clinical features,radiological findings and course of the IDAVF with spinal cord venous drainage were described in 3 patients with review of literatures.Results:The cerebral indications were found in one patient.The spinal cord myelopathy was only found in two patients.Conclusion:The clinical symptoms of IDAVF with spinal cord venous drainage are relative to the pathway of the radical venous drainage in spinal channel.The diagnosis of this disease is proved by cerebral angiography.The features of myelopathy are slow,aggressive and ascending,while degenerative changes of myelopathy appear suddenly,especially in younger.The causes are relative to the edema in cervical spinal cord,hypoxidosis and the age of patients.