Picard Luc, Bracard Serge, Anxionnat René
Neuroradiologie Diagnostique et Thérapeutique, Pôle Neuro tête et Cou. CHU, Hopital Neurologique, 29 Avenue Maréchal de Lattre de Tassigny, 54035 Nancy Cedex.
Bull Acad Natl Med. 2009 Apr;193(4):873-81.
First developed in the 1960s, interventional neuroradiology has vastly improved the management of patients with vascular diseases of the brain and spine, including vascular malformations and stroke. Gradually replacing open-skull neurosurgical approaches, endovascular occlusion of ruptured intracranial aneurysms has improved the post-bleed prognosis. With the increasing number of fortuitously discovered aneurysms, international randomized studies are being organized to determine whether preventive treatment is better than abstention. A wide range of therapeutic strategies are available for brain arteriovenous malformations, including hyperselective embolization, open-skull surgery, radiosurgery, and abstention. The choice depends on multiple parameters, including symptoms, clinical status, the angioarchitecture of the malformation, and the patient's psychology and wishes (...).
介入神经放射学最早于20世纪60年代发展起来，极大地改善了对脑和脊柱血管疾病患者的治疗，包括血管畸形和中风。颅内破裂动脉瘤的血管内闭塞逐渐取代了开颅神经外科手术方法，改善了出血后的预后。随着偶然发现的动脉瘤数量不断增加，正在组织国际随机研究以确定预防性治疗是否优于不进行治疗。对于脑动静脉畸形有多种治疗策略可供选择，包括超选择性栓塞、开颅手术、放射外科治疗以及不进行治疗。选择取决于多个参数，包括症状、临床状况、畸形的血管结构以及患者的心理和意愿（...）。
