妊娠期脑动静脉畸形的临床特征与治疗
The clinical characteristics and treatment of cerebral AVM in pregnancy.
作者信息
Lv Xianli, Liu Peng, Li Youxiang
机构信息
Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China.
Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, China
出版信息
Neuroradiol J. 2015 Jun;28(3):234-7. doi: 10.1177/1971400915589692.
Cerebral arteriovenous malformation (AVM) in pregnancy is a complex situation and there is no agreement on its hemorrhage risk and treatment. Although studies on bleeding risk of cerebral AVMs in pregnancy are very few, and they provide different results, pregnancy will increase the hemorrhagic risk of AVM and ruptured cerebral AVM in pregnancy should be actively treated. After intracranial hemorrhage, cerebral angiography should be performed for pregnant women shielded correctly. Cerebral angiography could clearly demonstrate the characteristics of cerebral AVM. Results from the literature show that the radiation dose of endovascular and stereotactic radiotherapy for cerebral AVM in pregnancy was below the safety value and was safe. For an unruptured AVM in pregnancy, if there are no bleeding factors, e.g. no coexisting aneurysm, smooth venous drainage, no venous ectasia, or high risk of treatment, then it should be observed conservatively.
妊娠期脑动静脉畸形（AVM）是一种复杂的情况，关于其出血风险和治疗尚无共识。尽管关于妊娠期脑AVM出血风险的研究很少，且结果各异，但妊娠会增加AVM的出血风险，妊娠期破裂的脑AVM应积极治疗。颅内出血后，应对正确防护的孕妇进行脑血管造影。脑血管造影可清晰显示脑AVM的特征。文献结果表明，妊娠期脑AVM血管内和立体定向放射治疗的辐射剂量低于安全值，是安全的。对于妊娠期未破裂的AVM，如果没有出血因素，如无并存动脉瘤、静脉引流顺畅、无静脉扩张或治疗风险高，则应保守观察。
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