先天性头皮动静脉瘘6例诊治分析

Diagnosis and treatment of congenital scalp arteriovenous fistulas:report of 6 cases and literature review

目的探讨头皮动静脉瘘的诊断及治疗方法。方法回顾性分析2010年12月至2021年12月收治的6例先天性头皮动静脉瘘的临床资料。结果6例均经DSA确诊为头皮动静脉瘘,其中5例行手术切除后完全治愈,1例经超声定位、局部压迫瘘口后症状消失。术后随访3个月~4年,复查血管彩色多普勒超声、CTA或DSA,未发现复发。结论DSA是诊断头皮动静脉瘘的金标准,彩色多普勒超声在术前诊断、术中仔细识别血管构筑特征、术后复查有重要作用。手术阻断供血动脉、灼闭瘘口是首选治疗方法,皮瓣设计要考虑术后头皮血供。

Objective To summarize the experience in the diagnosis and treatment of congenital scalp arteriovenous fistulas.Methods The clinical data of 6 patients with congenital scalp arteriovenous fistula who were admitted to our hospital from December 2010 to December 2021 were retrospectively analyzed.Results All the 6 patients were diagnosed as scalp arteriovenous fistula by DSA.Of these 6 patients,5 patients were completely cured by surgical resection,and 1 by local compression of the fistula using ultrasound localization.All patients were followed up for 3 months to 4 years.Reexamination of color Doppler ultrasound,CTA or DSA showed no recurrence.Conclusions DSA is the gold standard for the diagnosis of scalp arteriovenous fistulas.Color Doppler ultrasound plays an important role in preoperative diagnosis,intraoperative identification of vascular architecture characteristics and postoperative follow up.Surgical occlusion of the feeding artery and cauterization of the fistula are the preferred treatment methods.The postoperative scalp blood supply should be considered when designing the flap before operation.