Zenteno Marco, Lee Angel, Satyarthee Guru Dutta, Moscote-Salazar Luis Rafael
Neuroendovascular Therapy, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suarez", Mexico City, Mexico.
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
J Neurosci Rural Pract. 2018 Jul-Sep;9(3):406-409. doi: 10.4103/jnrp.jnrp_455_17.
Intracranial pial fistulas are an extremely uncommon type of vascular pathology consisting of one or multiple arterial connections to a single venous drainage channel without the presence of an intervening nidus. Due to its typical location and high-flow dynamics, its management is difficult and options include endovascular treatment and open surgical treatment. The arterial supply of these lesions is usually derived from pial or cortical vessels, and commonly such lesions are not localized in the dura mater.
Authors report the experience of consecutive ten cases managed at the Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" of México extending from 2007 to 2012 with endovascular technique, constituting one of the largest series in the Western literature.
Pial fistulas are associated with a poor natural history, and the selection of individualized therapeutic strategies can provide good outcomes.
The neuroendovascular intervention is currently considered as safe, low cost, and effective management modality for such lesions.
颅内软膜瘘是一种极为罕见的血管病变类型，由一条或多条动脉与单一静脉引流通道相连，中间无异常血管团。因其典型的位置和高流量动力学特点，其治疗颇具难度，治疗选择包括血管内治疗和开放手术治疗。这些病变的动脉供血通常源自软膜或皮质血管，且此类病变通常不在硬脑膜内。
作者报告了墨西哥国立神经病学与神经外科学研究所“曼努埃尔·贝拉斯科·苏亚雷斯”自2007年至2012年采用血管内技术连续治疗的10例病例经验，这是西方文献中最大的系列病例之一。
软膜瘘的自然病程较差，选择个体化治疗策略可取得良好疗效。
目前，神经血管内介入治疗被认为是此类病变安全、低成本且有效的治疗方式。
