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面部创伤后动静脉畸形:一例报告。

Posttraumatic arteriovenous malformation of the face: a case report.

作者信息

Kao Solon T, Walker Patrick W, Ferguson Henry W

机构信息

Department of Oral and Maxillofacial Surgery, Georgia Regents University, Augusta, Georgia.

出版信息

J Emerg Med. 2014 Jan;46(1):e5-8. doi: 10.1016/j.jemermed.2013.08.062. Epub 2013 Nov 5.

Abstract

BACKGROUND

Head and neck arteriovenous malformations (AVMs) are reported to occur in 0.1% of the population. Extracranial AVMs account for only 8.1% of head and neck AVMs. Of these, traumatically acquired AVMs of the face are generally reported as quite rare. When secondary to trauma, the lesion is usually supplied by a single vessel, as compared to the multiple vessels often seen with congenital etiology.

OBJECTIVES

Understanding of regional anatomy is paramount when assessing and managing facial injuries. As an integral health care provider for the facial trauma patient, it is the responsibility of the emergency physician to recognize this rare pathologic lesion necessary to coordinate surgical management of the traumatic AVM.

CASE REPORT

We present a case report of a patient who sustained a facial laceration complicated by the development of a vascular malformation. The facial laceration in this case report highlights the complexity of wound evaluation and management when treating patients in the emergency department.

CONCLUSION

Traumatic AVMs are quite rare in the head and neck and are mostly seen in the extremities. Although rare, they have been reported after typical facial trauma as well as elective surgical procedures. The management of such lesions may include selective embolization or surgical exploration with ligation. Emergency physicians and facial trauma surgeons are challenged with recognizing and treating these rare but very real vascular lesions. It is our hope that this case report provides an overview of posttraumatic AVMs in the head and neck.

摘要

背景

据报道,头颈部动静脉畸形(AVM)在人群中的发生率为0.1%。颅外AVM仅占头颈部AVM的8.1%。其中,面部创伤性获得性AVM通常被报道为相当罕见。继发于创伤时,与先天性病因常见的多支血管供血相比,病变通常由单一血管供血。

目的

在评估和处理面部损伤时,了解局部解剖结构至关重要。作为面部创伤患者不可或缺的医疗服务提供者,急诊医生有责任识别这种罕见的病理病变,以便协调创伤性AVM的手术治疗。

病例报告

我们报告一例面部裂伤并发血管畸形的患者。本病例报告中的面部裂伤突出了在急诊科治疗患者时伤口评估和处理的复杂性。

结论

创伤性AVM在头颈部相当罕见,多见于四肢。尽管罕见,但在典型面部创伤以及择期外科手术后均有报道。此类病变的处理可能包括选择性栓塞或手术探查及结扎。急诊医生和面部创伤外科医生在识别和治疗这些罕见但确实存在的血管病变方面面临挑战。我们希望本病例报告能对头颈部创伤后AVM进行概述。

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