George B, Celis-Lopez M, Kato T, Lot G
Department of Neurosurgery, Hôpital Lariboisière, Paris, France.
Acta Neurochir (Wien). 1992;116(2-4):119-27. doi: 10.1007/BF01540864.
AVMs of the posterior fossa are reviewed on the basis of personal experience of 47 cases including 2 venous angiomas, 7 cavernous angiomas, 5 arteriovenous fistulas and 33 true arteriovenous malformations and of the few series reported in the literature. MRI is now an indispensable tool to define the exact localization of any malformation. Combined with angiography, it permits one to choose the most adequate therapeutic strategy and the best surgical approach. Radical cure is to be contemplated in most cases considering the often dramatic consequences of bleeding at the infratentorial level. Deep AVMs and moreover cavernous angiomas, even those located in highly functional structures such as the brain stem, can now be discussed for treatment. Encouraging results have already been obtained using, alone or in association, the recently advanced modalities of treatment: interventional neuroradiology, radiosurgery, and microsurgery.
基于本人47例后颅窝动静脉畸形(包括2例静脉血管瘤、7例海绵状血管瘤、5例动静脉瘘和33例真性动静脉畸形)的经验以及文献中报道的少数系列病例,对后颅窝动静脉畸形进行综述。磁共振成像(MRI)现在是确定任何畸形确切位置的不可或缺的工具。结合血管造影,它能使人们选择最适当的治疗策略和最佳的手术方法。考虑到幕下出血往往会产生严重后果,大多数情况下应考虑进行根治性治疗。深部动静脉畸形,尤其是海绵状血管瘤,即使位于脑干等功能高度重要的结构中,现在也可以讨论治疗方案。单独或联合使用最近先进的治疗方式:介入神经放射学、放射外科和显微外科,已经取得了令人鼓舞的结果。