Rudnik Adam, Bazowski Piotr, Wojtacha Maciej, Krawczyk Ireneusz, Gamrot Jacek, Zawadzki Tomasz, Zdeb Marek
Katedry i Kliniki Neurochirurgii Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 2006;59(11-12):801-4.
A risk of haemorrhage in arteriovenous malformations (AVM) of the brain is estimated as 2-4% per year. A mortality rate from this reason is estimated as 1% per year and morbidity 10-20%. The methods of treatment ofAVM are: microsurgical treatment, radiosurgery, endovascular treatment. The aim of this work is presentation of our results of surgical treatment of AVM and comparison with the results of radiosurgical and endovascular treatment presented by other authors in the literature.
Between 1990-2002 in the Department of Neurosurgery of Medical University of Silesia in Katowice 31 patients were operated with AVM's of the brain. Among them there were 10 female and 21 male at the age from 10 to 69 years. The average age was 36.1. The first sign was intracranial haemorrhage in 19 cases and epileptic seizures in 9 cases. In all cases the cerebral angiography was performed and all patients were assessed as I to III score according to the Spetzler-Martin scale. All patients were operated on using microneurosurgical techniques. The total removal of the tumour was assessed using the intraoperative Doppler examination. The state of the patients at the discharge was estimated according to Glasgow Outcome Scale (GOS).
In all cases the malformations were removed totally. In 2 cases (6.4%) we noticed the deterioration of neurological condition after operation. The state of 28 patients (90.3%) was assessed as very good and good (I or II score) according to GOS at the discharge. We didn't notice any mortality in our group of patients.
In the conclusion we want to emphasize the advantages of surgical treatment of AVM's of the brain especially these including in I to III score according to Spetzler-Martin scale comparing with the results ofradiosurgical and endovascular methods of treatment.
脑动静脉畸形(AVM)的出血风险估计为每年2% - 4%。由此导致的死亡率估计为每年1%,致残率为10% - 20%。AVM的治疗方法有:显微外科治疗、放射外科治疗、血管内治疗。本研究的目的是展示我们对AVM进行外科治疗的结果,并与其他作者在文献中报道的放射外科和血管内治疗结果进行比较。
1990年至2002年期间,在卡托维兹西里西亚医科大学神经外科,对31例脑AVM患者进行了手术。其中女性10例,男性21例,年龄在10岁至69岁之间。平均年龄为36.1岁。首发症状为颅内出血19例,癫痫发作9例。所有病例均进行了脑血管造影,并根据斯佩茨勒 - 马丁量表将所有患者评估为I至III级。所有患者均采用显微神经外科技术进行手术。使用术中多普勒检查评估肿瘤是否完全切除。根据格拉斯哥预后量表(GOS)评估患者出院时的状况。
所有病例中的畸形均被完全切除。2例(6.4%)患者术后出现神经功能恶化。出院时,根据GOS,28例患者(90.3%)的状况被评估为非常好或良好(I级或II级)。我们的患者组中未发现任何死亡病例。
在结论中,我们想强调脑AVM外科治疗的优势,特别是对于那些根据斯佩茨勒 - 马丁量表评估为I至III级的病例,与放射外科和血管内治疗方法的结果相比。