Bun Yung Yu, Ming Cheng Kin, Ming Chiu Hok, Ling Cheung Yuk, Ming Chan Chi
Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, People's Republic of China.
Childs Nerv Syst. 2009 Mar;25(3):383-7. doi: 10.1007/s00381-008-0753-y. Epub 2008 Dec 11.
Over the years, patients presented with cerebrofacial vascular malformations which occurred in clusters. The syndromic presentation suggested angio-architectural abnormality, which started to develop during embryogenesis. The segmentation of the neural tube could provide a rational explanation for such a neuropathological phenomenon. Based on this theory, cerebrofacial arteriovenous metameric syndrome (CAMS) was derived. This describes clinical association between arteriovenous malformations of the face, retina, and brain. In this case's presentation, the syndromic presentation of the patient provided further evidence to the theory.
The authors report a case of a male neonate presenting with heart failure at birth. He was found to have a left sigmoid dural arteriovenous fistula (dAVF), an upper lip arteriovenous malformation (AVM), and a capillary hemangioma over the nose. The neuropathological clustering of vascular lesions is suggestive of CAMS. The patient was successfully treated with endovascular treatment and showed normal development during our follow-up assessment.
With the evolving evidence for the embryo-developmental theory for the clustering of angio-pathological lesions, further study and development of pathophysiology should be continued in following this track of theory. The success of endovascular intervention has warranted a favorable treatment option.
多年来,有患者出现成簇发生的脑颜面血管畸形。综合征表现提示血管构筑异常,这种异常始于胚胎发育过程。神经管的节段化可为这种神经病理现象提供合理的解释。基于这一理论,衍生出了脑颜面动静脉节段性综合征(CAMS)。它描述了面部、视网膜和脑部动静脉畸形之间的临床关联。在本病例报告中,患者的综合征表现为该理论提供了进一步的证据。
作者报告了一例男性新生儿,出生时即出现心力衰竭。发现他患有左侧乙状窦区硬脑膜动静脉瘘(dAVF)、上唇动静脉畸形(AVM)以及鼻部毛细血管瘤。血管病变的神经病理成簇现象提示为CAMS。该患者通过血管内治疗成功治愈,在我们的随访评估期间发育正常。
随着血管病理病变成簇的胚胎发育理论证据不断演变,应沿着这一理论轨迹继续进行病理生理学的进一步研究和发展。血管内介入治疗的成功为一种良好的治疗选择提供了依据。