临床小儿外科杂志2025，Vol.24Issue(2)：109-113,5.DOI:10.3760/cma.j.cn101785-202412015-002
儿童脑动静脉瘘的临床表现、血管构筑特征及治疗结局分析
Clinical manifestations,vascular architecture characteristics and treatment outcomes of pediatric cere-bral arteriovenous fistula
摘要
Abstract
Objective To summarize the treatment protocols and clinical outcomes of pediatric cerebral arteriovenous fistula(AVF)and explore the clinical and radiological characteristics as well as factors associated with therapeutic efficacy.Methods A retrospective analysis was conducted for the relevant clinical data of 24 children with cerebral AVF admitted into Department of Neurosurgery,Children's Hospital of Fudan University from October 2016 to October 2024.The clinical manifestations,radiological features,treatment protocols and prognostic follow-ups were summarized.Results There were 16 boys and 8 girls with an average age of(3.1±2.89 year)(2.5 month-10 year).The clinical manifestations included hemiplegia(n=7),intracranial hem-orrhage(n=7),epilepsy(n=7),developmental delay(n=6),facial and scalp venous dilation(n=5),headache(n=5),expanded head circumference(n=4),heart failure in 1 case and exophthalmos(n=1).The clinical types were pial AVF(n=15),dural AVF(n=4)and Galen vein aneurysmal malformation(n=5).All of them received interventional treatment and 6 cases had gamma knife treatment after interventional therapy.During a follow-up period of(51.7±26.39)(6.9-98.3)month.the outcomes were radiological cure(n=10)and good clinical prognosis(n=18).Presence of venous sinus reflux(P=0.017),co-existence of other vascular malformations(P=0.046),occurrence of postoperative complications(P=0.011)and radio-logical cure(P=0.017)were risk factors affecting clinical outcomes.Multiple arterial supplies(P＜0.001),multiple fistulas(P=0.005)and drainage through transverse sinus(P=0.034)were factors associated with radiological cure.Conclusions Pediatric cerebral AVF presents with diverse clinical manifestations.Endovas-cular interventional treatment is both safe and effective and its efficacy is correlated with vascular architecture of AVF.Complete obliteration of fistula contributes to favorable clinical outcomes.关键词
动静脉瘘,脑/症状和体征/介入治疗/伽马刀治疗/儿童Key words
Arteriovenous Fistula,Brain/Symptoms and Signs/Interventional Therapy/Gamma Knife Treatment/Child引用本文复制引用
张毅,薛萍,廖煜君,徐斌,田彦龙,李昊..儿童脑动静脉瘘的临床表现、血管构筑特征及治疗结局分析[J].临床小儿外科杂志,2025,24(2):109-113,5.基金项目
国家自然科学基金(82101810) National Natural Science Foundation of China(82101810) （82101810）
