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脊髓动静脉畸形的血管内治疗

Endovascular treatment of spinal cord arteriovenous malformations.

作者信息

Veznedaroglu Erol, Nelson Peter K, Jabbour Pascal M, Rosenwasser Robert H

机构信息

Department of Neurosurgery, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania 19147, USA.

出版信息

Neurosurgery. 2006 Nov;59(5 Suppl 3):S202-9; discussion S3-13. doi: 10.1227/01.NEU.0000237409.28906.96.

Abstract

Spinal cord arteriovenous malformations are rare lesions that represent one-tenth of the brain arteriovenous malformations. Depending on their location and relationship to the dura, these lesions are divided into four categories. Their clinical manifestations may vary from mild symptoms to severe motor deficits. Spinal angiography remains the "gold standard" for diagnosing spinal cord vascular lesions. Although the type of shunting remains difficult to determine by the magnetic resonance imaging, it is well analyzed by spinal angiography. The cure of the shunting is not by itself a therapeutic goal, but the objective is the creation of a new hemodynamic equilibrium between the lesion and the spinal cord to decrease the risk of hemorrhage and prevent the progression of the spinal cord ischemia. The endovascular tools seem to be a reasonable therapeutic option for the treatment of the majority of the spinal cord arteriovenous malformations.

摘要

脊髓动静脉畸形是罕见病变,占脑动静脉畸形的十分之一。根据其位置及与硬脑膜的关系,这些病变分为四类。其临床表现可能从轻微症状到严重运动功能缺损不等。脊髓血管造影仍是诊断脊髓血管病变的“金标准”。尽管磁共振成像难以确定分流类型,但脊髓血管造影能很好地进行分析。治愈分流本身并非治疗目标,目标是在病变与脊髓之间建立新的血流动力学平衡,以降低出血风险并防止脊髓缺血进展。血管内治疗手段似乎是治疗大多数脊髓动静脉畸形的合理选择。

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