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目的 探讨脑动静脉畸形 (AVM )血管内介入治疗的方法和效果。方法 分析 82例AVM ,其中表现癫痫 2 0例 ,颅脑出血 5 1例 ,头痛 18例 ,其他 8例。病灶位于大脑半球 6 6例 ,基底节 6例 ,小脑半球 7例 ,脑干 3例。畸形血管团属巨大型 2 3例 ,中型 5 0例 ,小型 9例。栓塞剂为NBCA6 4例 ,IBCA 12例 ,手术丝线 4例 ,手术丝线 +IBCA 2例。结果 完全解剖治愈 2 7例 ;畸形血管团减少80 %以上 15例 ;减少 5 0 %～ 80 %者 2 8例 ;小于 5 0 %者 12例。栓塞后手术切除 5例。生活工作正常者5 2例 ,症状明显改善者 2 0例 ,症状无改善者 8例 ,加重 2例 ,无死亡病例。并发症血管痉挛 7例 ,脑过度灌注综合征 3例 ,导管断裂 3例 ,误栓 1例。结论 血管内栓塞治疗脑动静脉畸形是安全有效的 ,对某些病例可达到解剖治愈 ,对手术困难的可作为首选方法
Objective To investigate the method and effect of endovascular interventional therapy of cerebral arteriovenous malformation (AVM). Methods 82 cases of AVM were analyzed, including 20 cases of epilepsy, 51 cases of cerebral hemorrhage, 18 cases of headache and the other 8 cases. The lesions were located in 6 6 hemispheres, 6 basal ganglia, 7 cerebellum hemispheres and 3 brainstem. Malformation vascular group is a huge 23 cases, medium 50 cases, small 9 cases. Embolic agents were 4 cases of NBCA6, 12 cases of IBCA, 4 cases of surgical silk, 2 cases of surgical silk + IBCA. The results of complete anatomy and cure 27 cases; deformity vascular groups reduced more than 80% in 15 cases; 50% to 80% reduction in 28 cases; less than 50% in 12 cases. Surgical resection in 5 cases after embolization. 52 cases of normal working life, symptoms were significantly improved 20 cases, no improvement in 8 cases, aggravated in 2 cases, no deaths. Complications of vascular spasm in 7 cases, brain perfusion syndrome in 3 cases, 3 cases of catheter rupture, misdiagnosis in 1 case. Conclusions Endovascular embolization is safe and effective in the treatment of cerebral arteriovenous malformations. Anatomical cure can be achieved in some cases and the first choice for surgical difficulties