摘要
目的总结颅颈交界区硬脊膜动静脉瘘的诊疗体会。方法回顾性分析11例颅颈交界区硬脊膜动静脉瘘的临床资料。结果颅颈交界区硬脊膜动静脉瘘患者11例,男10例,女1例。10例手术患者均于术中使用吲哚菁绿荧光造影证实瘘口消失,并于术后复查血管造影,瘘口均消失;术后随访10个月~5年,1例死于术后迟发性出血,其余患者预后良好。1例无症状患者拒绝手术,随访5年无新发症状。结论颅颈交界区硬脊膜动静脉瘘以中老年男性多见,多表现为蛛网膜下腔出血,也可表现为脊髓水肿症状。脊髓MRI可对其初步诊断,选择性血管造影是诊断本病的金标准。及早规范的手术治疗可能取得较好疗效。
Objective To summarize the experience in the diagnosis and treatment of craniocervical junction dural arteriovenous fistula.Methods The clinical data of 11 patients with dural arteriovenous fistula at craniocervical junction were analyzed retrospectively.Results The craniocervical junction dural arteriovenous fistula was diagnosed in 11 patients including 10 males and 1 female.The fistula disappeared in all the 10 patients confirmed by intraoperative indocyanine green fluorescence angiography and angiography after operation.The patients were followed up for 10 months to 5 years,during which one patient died of delayed bleeding and the others had a good prognosis.One patient with asymptomatic dural arteriovenous fistula refused to accept surgery and no new symptoms were found during years follow up.Conclusion Dural arteriovenous fistulas at craniocervical junction are more common in middle-aged and elderly men.Subarachnoid hemorrhage and spinal cord edema are the common manifestations.Spinal cord MRI can be used for its preliminary diagnosis.Selective angiography is the golden standard for the diagnosis.Early and standardized surgical treatment may achieve better results.
作者
陈鑫华
许天助
王毅
杨咏波
CHENXinhua;XU Tianzu;WANG Yi(Department of Neurosurgery, Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, CHINA)
出处
《江苏医药》
CAS
2019年第6期572-575,F0003,共5页
Jiangsu Medical Journal
关键词
硬脊膜动静脉瘘
蛛网膜下腔出血
Spinal dural arteriovenous fistula
Subarachnoid hemorrhage
