摘要
目的 增强临床医师对伴有髓周动静脉瘘的不典型硬脊膜动静脉瘘的认识。 方法回顾分析 3例硬脊膜动静脉瘘伴髓周动静脉瘘患者的临床与影像学特征及手术治疗情况。 结果3例患者的临床表现与典型的硬脊膜动静脉瘘差异不大 ,通过反复脊髓血管造影证实其伴有脊髓前动脉供血的硬脊膜动静脉瘘。 3例患者均行手术治疗 ,术后症状全部改善。 结论 全面的脊髓血管造影对硬脊膜动静脉瘘的诊断是必要的 ,有助于发现另外的瘘口 ;伴髓周动静脉瘘的硬脊膜动静脉瘘的治疗关键在于成功地阻断硬脊膜支和脊髓动脉向瘘口的供血。
Objective To enhance the clinical doctors' cognizance of atypical spinal dural arteriovenous fistulae(SDAVFs) associated with perimedullary anteriovenous fistulae(PMAVFs). Methods The clinicl imaging and surgical therapy of 3 patients with PMAVFs were analyzed retrospectively. Results The clinical presentations of the 3 patients were not significantly different from those of typical SDAVFs. They were verified by repeated spinal angiography that the anterior spinal artery (ASA) is supplied to the drainage vein. The 3 patients were treated surgically. First two operations were performed to eleminate the supply of ASA and dural branch, then the supply of the dural branch was amputated, and finally both the ASA and dural branch supplies were excised successfully. Clinical symptoms of the 3 patients were improved after treatment. Conclusions It is necessary to perform thorough spinal angiography in patients with SDAVFs to exclude another fistula.The key point in the treatment of such patients is successfully to terminat both the spinal feeder and dural branch feeder.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2002年第3期191-193,T002,共4页
Chinese Journal of Surgery