摘要
Abstract
Objective To investigate the efficacy of treatment methods in patients with high-grade intracranial arteriovenous malformations (AVMs). Methods The clinical data of 23 patients with high-grade AVMs treated with microsurgery were analyzed retrospectively. There were 15 males and 8 females in the study. Their mean age was 18 ±6 years. The Spetzler-Martin grade: 13 patients with grade IV and 10 with grade V . The long diameter of nidi was 3.5 to 15 cm (mean 7.5 ± 2. 0 cm). All the patients received microsurgery. Two of them had received embolization therapy in other hospitals before admission, 3 received preoperative embolizations recently, and 18 were operated directly. Five patients with partial residual nidus after resection were treated with Gamma knife. Results Three patients with recent embolization + surgical resection before operation had a good recovery after resection, The in postoperative Glasgow Outcome Scale ( GOS) scores were 4 in 1 case and 5 in 2 cases. There were 2 patients had embolization + surgery before,and 18 patients underwent direct microsurgery. One patient had coma and quadriplegia and 1 died after AVM resection. The GOS scores were 5 in 12 cases, 4 in 5 cases, 3 in 1 case, 2 in 1 case, and 1 in 1 case. (2)17 patients received postoperative DSA reexamination, one received MRA reexamina-tion, the AVMs of 11 patients were resected completely, 6 were nearly total resected, and 1 was partially resected. The mortality rate was 4% (1/23) , and the severe disability rate was 4. 5% (1/22). (3)The patients were followed up for 1 to 95 months. The GOS score was 5 in 14 cases, 4 in 6 cases, 3 in 2 cases,
and 1 in 1 case. Conclusion Microsurgical resection of high-grade AVM is the chief treatment method for high grade arteriovenous malformation, it has definite curative effect. Appropriate preoperative emboliza-tion is an important assistant means for the success of the AVM microsurgery.关键词
颅内动静脉畸形/显微外科手术/栓塞,治疗性/高级别颅内动静脉畸形Key words
Intracranial arteriovenous malformations/ Microsurgery/ Embolisation, therapeutic/High-grade arteriovenous malformations
