脑静脉畸形1例分析并文献复习

Analysis of a case of cerebral venous malformation and literature review

目的探讨脑静脉畸形(cerebral venous maiformation,CVM)的临床表现、病理机制、影像学特点、治疗方法及相关文献复习。方法对河南大学人民医院神经内科接诊的1例患者进行抽血及影像学检查,并结合国内外报道的病例进行文献复习并分析鉴别诊断。结果本例患者由癫痫发作引起突发意识丧失,影像学表现为长T1短T2信号影,增强见中央静脉干及周围放射状髓静脉强化,即"水母"征或"树根"征,SWI上呈低信号,DSA检查可确诊。结论脑静脉畸形大多以头痛、头晕、癫痫、出血为主要临床表现,病理机制为畸形血管静脉壁缺乏平滑肌和弹性组织,影像学具有特征性表现,治疗上首选保守治疗,同时需注意与其他脑血管畸形进行鉴别.

Objective To investigate the clinical manifestations,pathological mechanisms,imaging features,treatment methods and related literature review of cerebral venous maiformation(CVM).Methods A patient received in our department was examined by blood sampling and imaging examination,and the literature was reviewed and the differential diagnosis was analyzed combined with the cases reported at home and abroad.Results In this patient,the sudden loss of consciousness was caused by seizure.The imaging findings were long T1 short T2 signal,and the enhanced scan showed central venous trunk and peripheral radial venous intensification,which was characterized by"Jellyfish"sign or"Root"sign.The lesion showed a low signal on the SWI and the DSA examination confirmed the diagnosis.Conclusion Most of the cerebral venous malformations are mainly caused by headache,dizziness,epilepsy and hemorrhage.The pathological mechanism is that the deformed vascular vein wall lacks smooth muscle and elastic tissue.Imaging has a characteristic performance.Conservative treatment is preferred,and other cerebrovascular malformations should be identified.