Fassett Daniel R, Schloesser Peter E, Couldwell William T
Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA.
J Neurosurg. 2004 Nov;101(5):869-71. doi: 10.3171/jns.2004.101.5.0869.
The authors describe a case of subarachnoid hemorrhage from moyamoya-like vessels associated with an arteriovenous malformation (AVM) in a 44-year-old Hispanic man who presented with severe headache. The AVM was located in the left parietal lobe and the ipsilateral middle cerebral artery was occluded. Although the patient was initially neurologically intact, he began to experience neurological deficits from mild vasospasm, illustrating the sensitivity of the underperfused portion of brain surrounding an AVM. His neurological deficits improved with aggressive hydration and elevated blood pressure. After a 3-week period, the AVM was resected without complication and all of the patient's neurological deficits resolved. The authors review radiographic findings of this unique case.
作者描述了一例44岁西班牙裔男性因类烟雾病样血管伴发动静脉畸形(AVM)导致蛛网膜下腔出血的病例,该患者表现为严重头痛。AVM位于左侧顶叶,同侧大脑中动脉闭塞。尽管患者最初神经功能完好,但他开始因轻度血管痉挛出现神经功能缺损,这说明了AVM周围灌注不足的脑区的敏感性。通过积极补液和升高血压,他的神经功能缺损得到改善。3周后,AVM被切除,无并发症发生,患者所有神经功能缺损均消失。作者回顾了这一独特病例的影像学表现。