中国卒中杂志 ›› 2016, Vol. 11 ›› Issue (08): 654-658.

• 论著 • 上一篇    下一篇

脑静脉畸形的诊断和治疗及文献回顾

康帅,叶迅,赵元立,王嵘,曹勇,张岩,张东,王硕,赵继宗   

  1. 100050 北京首都医科大学附属北京天坛医院神经外科
  • 收稿日期:2015-10-11 出版日期:2016-08-20 发布日期:2016-08-20
  • 通讯作者: 赵继宗 Zhaojz205@163.com

Diagnoses and Treatment as Well as Literature Review of Developmental Venous Anomalies

  • Received:2015-10-11 Online:2016-08-20 Published:2016-08-20

摘要:

目的 探讨脑静脉畸形的病理特点、临床表现、诊断和治疗,提高对静脉畸形的认识。 方法 结合文献学习,对我科近期住院治疗的10例静脉畸形病例进行回顾性分析。 结果 10例静脉畸形患者中,7例有出血史,2例有癫痫史,1例偶然发现;7例采取了保守治疗,3例合 并海绵状血管畸形出血,其中2例行手术治疗,1例静脉畸形行手术治疗,手术治疗患者预后较好,保 守治疗病情无进展。 结论 静脉畸形本身可以认为良性病变,一般不需要特别处理,但是合并海绵状血管畸形增加出血 风险,对于有出血史的患者,针对合并病变可以手术治疗。静脉畸形经全面评估后可以考虑手术切除。

文章导读: 脑静脉畸形无明显症状,一般可以观察,一旦出血可以积极治疗。

关键词: 静脉畸形; 发育性静脉畸形; 海绵状血管畸形; 出血; 癫痫

Abstract:

Objective To analyze the pathological characteristics, clinical manifestation, diagnosis and treatment of venous malformations (VMs), and to improve the clinical significance of its recognition. Methods A retrospective study and a literature study to review 10 patients with VMs from our hospital were performed. Results A total of 10 patients with VMs could be identified: intracerebral hemorrhage (n =7), seizures (n =2), non-neurological indication (n =1). Seven patients received conservative therapy and 3 patients were found associated cavernoma, among whom, two received operations and one VMS was resected. Those who received conservative therapy had no further disease progress and those who received operation had good prognosis. Conclusion Although VMs should be considered benign and clinically silent, coexisting cavernomas are found having a defined bleeding potential and should be treated independently of the VMS after overall evaluation.

Key words: Venous malformations; Developmental venous anomalies; Cavernous malformations; Hemorrhage; Epilepsy