与动脉化发育性静脉异常相关的海绵状畸形：一例报告
Cavernous Malformation Associated With Arterialized Developmental Venous Anomaly: A Case Report.
作者信息
Nakase Kenta, Motoyama Yasushi, Nakai Tokiko, Takeshima Yasuhiro, Nakagawa Ichiro, Park Young-Su, Ohbayashi Chiho, Nakase Hiroyuki
机构信息
Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan.
Pathology, Nara Medical Unive-rsity, Kashihara, Nara, Japan.
出版信息
Neurosurgery. 2017 Jun 1;80(6):E257-E262. doi: 10.1093/neuros/nyx065.
BACKGROUND AND IMPORTANCE
Formation of cavernous malformations (CMs) has been recognized to be associated with developmental venous anomaly (DVA) by many authors. Hemodynamic stress due to venous outflow restriction could be hypothesized as a cause. On the other hand, a rare subgroup of DVA with an arterial component has been reported as likely to hemorrhage or be symptomatic. Cases of arterialized DVAs reported previously have not been associated with the presence of CM.
CLINICAL PRESENTATION
We present herein a case report of arterialized DVA in the brainstem with repeated cerebellar hemorrhage. The 49-year-old patient was treated with surgical evacuation of hematoma. A surgical specimen from the hematoma cavity demonstrated CMs on histological examination.
CONCLUSION
To the best of our knowledge, this represents the first report of CM associated with an arterialized DVA. In addition to venous congestion due to outflow obstruction, bleeding from the arterial component of the DVA might be considered as a cause of CM formation.
背景与重要性
许多作者已认识到海绵状血管畸形（CMs）的形成与发育性静脉异常（DVA）有关。可推测静脉流出受限导致的血流动力学应激是一个原因。另一方面，据报道，一种罕见的具有动脉成分的DVA亚组可能会出血或出现症状。先前报道的动脉化DVA病例与CM的存在无关。
临床表现
我们在此报告一例脑干动脉化DVA伴反复小脑出血的病例。该49岁患者接受了血肿手术清除治疗。血肿腔的手术标本在组织学检查中显示为CMs。
结论
据我们所知，这是首例与动脉化DVA相关的CM报告。除了流出道阻塞导致的静脉充血外，DVA动脉成分的出血也可能被视为CM形成的一个原因。
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