摘要
目的分析和总结介入栓塞治疗脑干部位动静脉畸形的疗效。方法南方医科大学珠江医院神经外科自2000年4月至2015年3月收治17例脑干部位动静脉畸形患者，其中Spetzler-Martin分级Ⅰ级5例，Ⅱ级7例，Ⅲ级3例，Ⅳ级2例；单纯行介入栓塞治疗8例，介入栓塞结合伽玛刀放射治疗9例。回顾性分析患者的临床资料和疗效。结果单纯行介入栓塞治疗的8例患者术后全脑血管造影显示1例畸形团完全消失，残余畸形团减少2／3以上5例，减少1／3～2／32例；介入栓塞结合放射治疗的9例患者中6例畸形团完全消失，残余畸形团减少2／3以上1例，减少1／3～2／3者2例。15例患者术后2月～3年返院复查显示，2例患者偶述头痛；5例患者发现神经功能障碍，较治疗前临床症状加重；8例患者术后恢复良好，未留有任何神经系统阳性体征。结论根据脑干动静脉畸形的血管影像学特点，采取介入栓塞为主、放射治疗为辅的治疗策略，仍能取得较为良好的临床效果。
Objective To analyze and summarize the clinical therapeutic characteristics and efficacy of interventional embolization in cerebral arteriovenous malformation （AVM） in the brainstem. Methods A retrospective analysis was conducted on clinical data of 17 patients with cerebral AVM in the brainstem underwent principal interventional embolization and auxiliary gamma knife （GK） during the period from April 2000 to March 2015. According to the Spetzler-Martin grading, grade Ⅰ was noted in 5 patients, grade Ⅱ in 7, gradeⅢ in 3 and grade Ⅳ in two. Only interventional embolization was implemented in 8 patients; combination interventional embolization and GK was implemented in 9 patients. The treatment efficacy of them was analyzed. Results Postoperative DSA showed that in the 8 patients performed interventional embolization, one patient had 100% AVM disappearance, 5 had more than 2/3 AVM disappearance, and two had 1/3-2/3 AVM disappearance; in the 9 patients performed interventional embolization and GK, 6 patient had 100% AVM disappearance, one had more than 2/3 AVM disappearance, and two had 1/3-2/3 AVM disappearance. Follow up for two months to three years indicated that two had headache occasionally, 5 had neurological dysfunction which was severer than that before treatment, and 8 had good recovery without any nervous system positive signs. Conclusion The treatment for cerebral AVM in the brainstem is very knotty, but good therapeutic effect according to image characteristics can be achieved by adopting principal interventional embolization and auxiliary GK treatment.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2016年第1期70-74,共5页
Chinese Journal of Neuromedicine
基金
国家临床重点建设专科资助项目
国家自然科学基金（81271315）
广东省神经外科临床中心资助项目
广东省科技计划项目（2012B031800131）
关键词
脑干
脑动静脉畸形
介入栓塞治疗
放射治疗
Brainstem
Cerebral arteriovenous malformation
Interventional embolization
Radiotherapy
