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[术后血管造影显示消失的动静脉畸形复发——两例报告]

[Recurrence of AVM after disappearing on postoperative angiography--report of two cases].

作者信息

Fuwa I, Wada H, Matsumoto T

机构信息

Division of Neurosurgery, Oita Prefectural Hospital, Japan.

出版信息

No Shinkei Geka. 1988 Jun;16(7):887-91.

PMID:3065672
Abstract

We reported two cases of recurrent arteriovenous malformation (AVM), which had been operated on before and these AVMs disappeared on postoperative angiography. The first case was a 13-year-old boy who had suffered from intracerebral hematoma at the age of nine years. The first angiography showed AVM located in the left central region, fed by peripheral branches of the anterior and middle cerebral arteries. Sixteen days after the onset, removal of the AVM was carried out. Postoperative course was uneventful and angiography showed that the AVM had disappeared. However, 4 years later, follow-up digital subtraction angiography showed that the AVM had reappeared in the operated region. Extirpation of the recurrent AVM was repeated. The second case was a 28-year-old woman who had presented intracerebral hematoma at the age of 23 years. Angiography revealed AVM located in the right posterotemporal region, fed by a temporal branch of the middle cerebral artery. Removal of the AVM was carried out one month after the onset. Postoperative neurological status was good and angiography showed no residual AVM. Five years later, enhanced CT scan demonstrated a linear enhanced area in the operated region. This led us to suspect recurrence of the AVM. Conventional angiography presented reappearance of the AVM, and reoperation was performed. Reported cases of AVM, which recurred after disappearing on postoperative angiography, were very rare. Small abnormal vascular channels located in the surrounding area of the main nidus may be left after the initial operation, and they may have grown to nidus some years later.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们报告了两例复发性动静脉畸形(AVM)病例,这两例之前均接受过手术治疗,且术后血管造影显示AVM消失。第一例是一名13岁男孩,9岁时曾患脑内血肿。首次血管造影显示AVM位于左侧中央区,由大脑前动脉和大脑中动脉的外周分支供血。发病16天后,进行了AVM切除术。术后过程顺利,血管造影显示AVM已消失。然而,4年后,随访数字减影血管造影显示AVM在手术区域再次出现。对复发性AVM再次进行了切除。第二例是一名28岁女性,23岁时出现脑内血肿。血管造影显示AVM位于右侧后颞区,由大脑中动脉的颞支供血。发病1个月后进行了AVM切除术。术后神经状态良好,血管造影显示无残留AVM。5年后,增强CT扫描显示手术区域有一条线状强化区。这使我们怀疑AVM复发。传统血管造影显示AVM再次出现,于是进行了再次手术。术后血管造影显示消失后又复发的AVM报道病例非常罕见。初次手术时可能会残留位于主要畸形血管团周围区域的小异常血管通道,它们可能在数年后发展为畸形血管团。(摘要截短于250字)

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