Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island 2903, USA.
J Neurointerv Surg. 2012 Sep;4(5):e26. doi: 10.1136/neurintsurg-2011-010113. Epub 2011 Sep 28.
A cerebral arteriovenous fistula (CAVF) is a rare abnormality representing only 4.7% of all cerebral arteriovenous malformations. In this report a unique case is presented of a giant holo-hemispheric CAVF in an infant who presented with congestive heart failure and was successfully treated endovascularly with transarterial and transvenous embolization. A 4-day-old girl presented with lethargy and poor feeding and was found to be in congestive heart failure secondary to a large left hemispheric vascular malformation. Embolization was performed via a transarterial route on days of life (DOL) 11 and 18, a transvenous route on DOL 54 and a final transarterial treatment on DOL 76. After all treatment the patient was discharged home on minimal cardiac medications. At 2-year follow-up the patient had moderate motor delays and mild speech delays, but she continued to meet milestones and her cardiac failure was completely resolved. This case demonstrates one of the largest CAVFs treated successfully in the neonatal population.
大脑动静脉瘘（CAVF）是一种罕见的异常，仅占所有脑动静脉畸形的 4.7%。本报告介绍了一例独特的婴儿全脑半球性 CAVF 病例，该患者因充血性心力衰竭就诊，经动脉内和静脉内栓塞治疗成功。一名 4 天大的女孩表现出嗜睡和喂养不良，被发现患有充血性心力衰竭，继发于左半球大血管畸形。栓塞治疗分别在生后第 11 天和第 18 天行经动脉途径、生后第 54 天行经静脉途径、生后第 76 天行最后一次经动脉治疗。所有治疗结束后，患者出院时服用最小剂量的心脏药物。2 年随访时，患者有中度运动延迟和轻度言语延迟，但仍能达到发育里程碑，充血性心力衰竭完全缓解。该病例展示了新生儿人群中成功治疗的最大 CAVF 之一。
