Rutkowski Martin J, Jian Brian, Lawton Michael T
Department of Neurological Surgery, University of California, San Francisco, CA, USA.
Department of Neurological Surgery, University of California, San Francisco, CA, USA.
Handb Clin Neurol. 2017;143:107-116. doi: 10.1016/B978-0-444-63640-9.00010-2.
Dural arteriovenous fistulae are high flow, low resistance intracranial vascular malformations defined by an aberrant connection between an artery and dural vein or sinus. Symptomatology and presentation are highly dependent on location, generally categorized as supratentorial, tentorial, or infratentorial, and consist primarily of sequelae secondary to local venous hypertension, insufficiency, and cortical venous reflux. Surgery is generally reserved for high risk or persistently symptomatic lesions that are unamenable or unresponsive to endovascular therapy. For surgical lesions, familiarity with skull base approaches, specific fistula anatomy, and technical nuances based on fistula location offer patients the best chance of a favorable outcome.
硬脑膜动静脉瘘是一种高流量、低阻力的颅内血管畸形，其定义为动脉与硬脑膜静脉或静脉窦之间的异常连接。症状和表现高度依赖于位置，一般分为幕上、幕或幕下，主要由局部静脉高压、供血不足和皮质静脉反流引起的后遗症组成。手术通常适用于高风险或持续有症状的病变，这些病变不适用于血管内治疗或对其无反应。对于需要手术治疗的病变，熟悉颅底入路、特定的瘘管解剖结构以及基于瘘管位置的技术细节，能为患者提供获得良好预后的最佳机会。
