中国脑血管病杂志2017，Vol.14Issue(7)：367-370,375,5.DOI:10.3969/j.issn.1672-5921.2017.07.007
马尾神经根动静脉瘘的诊治分析
Diagnostic and treatment analysis of arteriovenous fistula of cauda equina
摘要
Abstract
Objective To investigate the diagnostic and treatment results of arteriovenous fistula of cauda equina.Methods From January 2000 to December 2015,9 Patients with arteriovenous fistula of cauda diagnosed and treated at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively,including 6 males and 3 females.Their ages were 17-58 (mean 39±14) years.The diagnoses were confirmed by digital subtraction angiography (DSA) or surgery (the lesions were located on the cauda equine,which were fed by the arterial supply of the nerve root,and the drainage vein flowed upward into the perimedullary vein).The clinical data,imaging data,and treatment follow-up results of the patients were analyzed.Results The patients presented with weakness of both lower extremities and disturbances of bowel movement and urination.Aminoff Logue score for spinal function was 7.2±3.2 before procedure.The median course of disease was 6.0 (4.5-18.0) months.Angiography showed that the vascular architecture types of the lesions were divided into simple fistula type and micro-nidus type.The feeding arteries were all the nerve root branches of the internal iliac artery.Three patients complicated with conical part of the intramedullary arteriovenous malformations.Eight patients were treated with endovascular embolization,one was treated by operation.No patients were treated with combined interventional surgery,and no surgery-related complications were observed.The mean follow-up duration was 20.1±6.7 months.Imaging follow-up showed that they all reached anatomic cure.Aminoff Logue score dropped to 4.6±2.8 after treatment.There were significant differences before and after treatment in Aminoff Logue score of the patients (t=4.276,P<0.05).Conclusions The nerve root arteriovenous fistula of the cauda equina can be diagnosed by DSA findings.Symptomatic patients are eligible for the indication of endovascular or surgical treatment.Anatomy and functional prognosis are satisfactory after treatment.关键词
脊髓动静脉畸形/马尾神经/动静脉瘘/影像学/疗效分析Key words
Spinal arteriovenous malformations/Cauda equina/Arteriovenous fistula/Imaging/Curative effect analysis引用本文复制引用
洪韬,张鸿祺,马永杰,李静伟,何川,叶明..马尾神经根动静脉瘘的诊治分析[J].中国脑血管病杂志,2017,14(7):367-370,375,5.基金项目
国家自然科学基金(81171165,81671202) （81171165,81671202）
北京市医管局扬帆计划(ZY201309) （ZY201309）
北京市科委重点项目(D161100003816001) （D161100003816001）
