脑动静脉畸形治疗进展

Progress in Diagnosis and Treatment of Brain Arteriovenous Malformations

脑动静脉畸形(bAVM)是脑动脉和静脉之间的直接连接而缺少毛细血管网的病症,通常由供血动脉、畸形血管团和引流静脉3部分组成。颅内出血、癫痫发作、非特异性头痛是bAVM最常见的临床表现。估计的累积终生出血风险与干预风险之间的平衡是制定治疗方案的决定性因素,完全闭合异常血管巢是bAVM干预的目标。目前主要干预措施包括显微外科手术、血管内栓塞治疗、立体定向放射治疗和保守治疗,各种方式之间的风险和优点各不相同,必要时可以组合使用。本文将从自然病史、临床诊断、治疗方法等方面展开,就bAVM诊治进展作一述评。

Brain arteriovenous malformation (bAVM) is a condition where there is a direct connection between cerebral arteries and veins without a capillary network. It usually consists of three parts: the supplying artery, the malformed vascular cluster, and the draining vein. Intracranial hemorrhage, epileptic seizures, and non-specific headaches are the most common clinical manifestations of bAVM. The balance between the estimated cumulative lifetime bleeding risk and intervention risk is the decisive factor in developing treatment plans, and the goal of bAVM intervention is to completely close the abnormal vascular nest. At present, the main intervention measures include microsurgery, endovascular embolization therapy, stereotactic radiotherapy, and conservative treatment. The risks and advantages of each method vary, and can be combined if necessary. This article will review the progress of bAVM diagnosis and treatment from the perspectives of natural medical history, clinical diagnosis, and treatment methods.