脑动静脉畸形手术的进展与创新。

Advances and innovations in brain arteriovenous malformation surgery.

机构信息

Northwestern Memorial Hospital, Departments of *Neurological Surgery, ‡Radiology, §Otolaryngology, and ¶Anesthesiology, Chicago, Illinois; ‖Northwestern University, McCormick School of Engineering, Department of Biomedical Engineering, Evanston, Illinois; Northwestern University, #Neuropsychology Institute, **Department of Medical Social Sciences, ‡‡Department of Physical Therapy and Human Movement Sciences, and §§Department of Chemistry, Chicago, Illinois; ¶¶University of Texas Southwestern, Department of Neurological Surgery, Dallas, Texas.

出版信息

Neurosurgery. 2014 Feb;74 Suppl 1:S60-73. doi: 10.1227/NEU.0000000000000230.

DOI:10.1227/NEU.0000000000000230

PMID:24402494

Abstract

Arteriovenous malformations (AVMs) of the brain are very complex and intriguing pathologies. Since their initial description by Luschka and Virchow in the middle of the 19th century, multiple advances and innovations have revolutionized their management and surgical treatment. Here, we review the historical landmarks in the surgical treatment of AVMs and then illustrate the most recent and futuristic technologies aiming to improve outcomes in AVM surgeries. In particular, we examine potential advances in patient selection, imaging, surgical technique, neuroanesthesia, and postoperative neuro-rehabilitation and quantitative assessments. Finally, we illustrate how concurrent advances in radiosurgery and endovascular techniques might present new opportunities to treat AVMs more safely from a surgical perspective.

摘要

脑动静脉畸形（AVM）是非常复杂和引人入胜的病理。自 19 世纪中叶 Luschka 和 Virchow 首次描述以来，多项进展和创新彻底改变了它们的管理和手术治疗。在这里，我们回顾了 AVM 手术治疗的历史里程碑，然后介绍了旨在改善 AVM 手术结果的最新和最具未来感的技术。特别是，我们研究了在患者选择、成像、手术技术、神经麻醉和术后神经康复以及定量评估方面的潜在进展。最后，我们说明了放射外科和血管内技术的同时进步如何为从手术角度更安全地治疗 AVM 提供新的机会。