以癫痫发病的脑AVM的影像特点与血管内治疗

The Characters of Images and Endovascular Embolization for Cerebral AVM with Epilepsy

目的 :探讨 2 6例以癫痫发病的脑AVM的影像学特点与血管内治疗的技术操作。材料和方法 :2 6例以癫痫发病的病例经DSA全脑血管造影证实为脑AVM。根据AVM病灶的特点 ,选择经血管内超选择应用NBCA栓塞或结合放射外科治疗。结果 :2 6例在 1～ 3次栓塞后 ,17例症状完全消除 ,9例症状得到明显有效的控制。结论 :AVM病灶粗大的皮层引流静脉产生的搏动性刺激及脑皮层静脉回流受阻 ,损害脑功能 ,进而引起皮层放电导致癫痫发作 ,所以在栓塞中应尽量减少畸形血流量 ,使粗大的引流静脉萎陷 ,从而降低对皮层脑组织的刺激 ,达到控制和缓解癫痫发作的目的。

Purpose: To discuss the characters of images and the technical manipulate of endovascular embolization for cerebral AVM with epilepsy in 26 cases. Materials and Methods: The cerebral AVM with epilepsy of all the cases were confirmed by cerebral DSA. According to the nidus of AVM, the superselective endovascular embolization with NBCA or embolization combined with radiological surgery were chosen. Results: The attack was eliminated in 17 cases after embolization for 1 to 3 processes. The symptoms in the other 9 cases were controlled obviously and effectively. Conclusion: The thick draining vein in the cortex stimulate the cortex pulsated, and the blood from veins of cortex were detained during circumfluence. All these damaged the function of brain and resulting attack of epilepsy. In order to control and release the attack, the flow of the nidus should be cut down as much as possible to withdraw the thick draining vein in the process of embolization.