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[脑动静脉畸形的神经外科治疗]

[Neurosurgical treatment of cerebral arteriovenous malformations].

作者信息

Höllerhage H G

机构信息

Neurochirurgische Klinik, Medizinischen Hochschule Hannover.

出版信息

Neurochirurgia (Stuttg). 1988 Sep;31(5):139-43. doi: 10.1055/s-2008-1053921.

Abstract

61 patients were treated from 1980 to 1984 for an arteriovenous malformation. Of these, 28 had suffered an acute haemorrhage, 33 were admitted for seizures, neurological deficits or intractable headaches. 55 patients underwent surgery. 4 patients rejected surgery and 2 malformations were not amendable to surgery. 55 patients were followed up for an average of 25 months (6-67 months), 53 of whom had undergone surgery. Good and excellent results were observed in 49 of 53 patients who had undergone surgery. 2 additional patients who were lost for follow-up had completely recovered and were without deficits on discharge. 4 patients who had undergone surgery for intracranial bleeding were moderately disabled on follow-up examination. No deaths occurred. There was a favourable effect of surgery on seizures. One half of the patients who had sporadic seizures preoperatively, remained without seizures without antiepileptic drugs. Of 9 patients who suffered from a manifest epilepsy preoperatively, 2 remained without seizures even without antiepileptic medication. We conclude from our results that not only arteriovenous malformations which have already bled but also those presenting with seizures, headaches, or neurological deficits, should be treated surgically unless they are not menable to surgery because of their location in the speech areas or the brain stem.

摘要

1980年至1984年期间,61例患者因动静脉畸形接受治疗。其中,28例曾发生急性出血,33例因癫痫发作、神经功能缺损或顽固性头痛入院。55例患者接受了手术。4例患者拒绝手术,2例畸形无法进行手术治疗。55例患者接受了平均25个月(6 - 67个月)的随访,其中53例接受了手术。53例接受手术的患者中,49例获得了良好和优异的结果。另外2例失访患者已完全康复,出院时无功能缺损。4例因颅内出血接受手术的患者在随访检查时中度残疾。无死亡病例。手术对癫痫发作有良好效果。术前有散发性癫痫发作的患者中,一半在未使用抗癫痫药物的情况下不再发作。术前患有明显癫痫的9例患者中,2例即使未使用抗癫痫药物也不再发作。我们从结果中得出结论,不仅已经出血的动静脉畸形,而且那些伴有癫痫发作、头痛或神经功能缺损的动静脉畸形,除非因其位于语言区域或脑干而无法进行手术,否则均应接受手术治疗。

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