Yamaguchi Shinya, Hamamura Takeshi, Ito Osamu, Sayama Tetsuro, Shimogawa Takafumi, Matsukado Koichiro, Morioka Takato
Department of Neurosurgery, Hamanomachi Hospital, Japan.
No Shinkei Geka. 2013 Mar;41(3):247-53.
A 43-year-old woman with progressive gait disturbance and dysesthesia of the limbs and trunk visited our hospital. Upon examination, a thoracocervical giant perimedullary arteriovenous fistula(GPMAVF)was detected. The GPMAVF was fed by both of the highest intercostal arteries and the thyrocervical trunk. The dilated drainage vein widely compressed the spinal cord from the upper thoracic to the cervical regions. Transarterial embolization with n-butyl 2-cyanoacrylate was performed, and the fistula was completely obliterated. The dilated drainage vein was thrombosed, and it decreased in size after treatment. The patient's symptoms and magnetic resonance imaging results significantly improved. We suggest that endovascular treatment is effective for GPMAVFs, given sufficient analysis of the anatomical architecture.
一名43岁女性，出现进行性步态障碍以及四肢和躯干感觉异常，前来我院就诊。经检查，发现一例胸颈段巨大髓周动静脉瘘（GPMAVF）。该GPMAVF由最高肋间动脉和甲状颈干供血。扩张的引流静脉从上胸部至颈部广泛压迫脊髓。采用2-氰基丙烯酸正丁酯进行经动脉栓塞，瘘口完全闭塞。扩张的引流静脉形成血栓，治疗后尺寸减小。患者的症状及磁共振成像结果显著改善。我们认为，在对解剖结构进行充分分析的情况下，血管内治疗对GPMAVF有效。
