摘要
我所自1958年至1991年1月共手术治疗颅内动静脉畸形800例,其中显微手术382例,死亡率1.6%。直视下手术418例,死亡率6.2%。10~40岁发病率最高,占74.3%。临床表现为颅内出血者597例,占74.6%。120例有癫痫发作,占15%。按畸形在脑部的深浅分型;位于脑浅部者,脑组织损伤可达到最小程度。位于脑深部者手术困难,但有血肿形成者可使手术相对容易,切除后一般不致出现新的神经功能障碍。硬脑膜动静脉畸形有明确供血动脉且远离大静脉窦者治疗容易,有颅内外双重供血,位于大静脉窦旁且有颅压增高者手术治疗困难。
From 1958 to 1991. 800 patients withAVMs were treated by surgical excision. Ofthese patients, 382 underwent microsurgical tech-nique, whose mortality rate was 1.57 percent and418 were treated with direct surgery, whose mor-tality rate was 6. 22 percent. The clinical mani-festation showed intracranial hemorrhage in 579 pa-tients (72.4%), epilepsy in 120 patients (15%).headache in 101 patients (12. 6%). Most of the pe-tients got intracranial hemorrhage and epilepsy be-tween 10 to 40 years The lesion was divided intothe two types (deep-seated AVMs and superficial-seated AVMs). The result demonstrated that su-perficial seated AVMs easy to excise the lesion.and less to injury the normal adjacent neural tissue.The deep-seated A V Ms was difficult to removethe nidus, if intracranial hematoma occured mayfacilitated to excise the AVMs. Excision of brain-stem AVMs may give rise hight risk. DuralAVMs involving the transerve or sigmoid sinuslead to increase increase intracranial pressure.Its arterial supply was recruited from dural arte-ries and cerebral arterits. Excision of this lesionwas very difficult. If with few feeding arteriesand far from larger venous sinus dural AVMswere removed without difficulty.
出处
《中华神经外科杂志》
CSCD
北大核心
1992年第3期158-160,共3页
Chinese Journal of Neurosurgery
