颅内单纯动脉畸形1例并文献回顾

Intracranial pure arterial malformations:report of one case and literature review

目的探讨颅内单纯动脉畸形(PAMs)临床特点、影像学表现以及治疗方式。方法回顾性分析德阳市人民医院神经外科2020年10月收治的1例典型的双侧大脑前动脉(ACA)单纯动脉畸形的患者,并运用随访的影像学资料及临床表现对单纯动脉畸形进行报道,以期为颅内单纯动脉畸形的诊断与治疗提供依据。结果脑血管造影示,双侧大脑前动脉A2段异常迂曲、扩张、线圈样走形的动脉环且静脉期未见明确静脉引流征象,故给予对症止痛治疗后出院。结论针对破裂出血、颅内单纯动脉畸形导致压迫效应(梗阻性脑积水、颅神经麻痹)、血流相关性动脉瘤的患者临床上应该积极手术干预,无上述特点的单纯动脉畸形选择定期影像学和临床随访的保守治疗策略。

Objective To explore the clinical characteristics,imaging findings,and treatment methods of intracranial pure arterial malformations(PAMs).Methods A retrospective analysis was conducted on a typical patient with bilateral anterior cerebral artery(ACA)of intracranial PAMs admitted to the neurosurgery department of our hospital.Imaging data and clinical manifestations from years of follow-up were used to report and review the literature,in order to provide a basis for the diagnosis and treatment of intracranial simple arterial malformation.Results Cerebral angiography showed abnormal tortuous,dilated,and coiled arterial rings in the A2 segment of the bilateral ACA,and no clear signs of venous drainage were observed during the venous phase.Therefore,symptomatic pain relief treatment was given and patients were discharged.Conclusions For patients with ruptured bleeding,compression effects caused by intracranial PAMs(obstructive hydrocephalus,cranial nerve paralysis),and blood flow related aneurysms,active surgical intervention should be taken in clinical practice.For simple arterial malformations without these characteristics,regular imaging and clinical follow-up should be chosen as conservative treatment strategies.