多次血管内治疗后小脑脑桥裂动静脉畸形的显微外科治疗
Microsurgical treatment for cerebellomesencephalic fissure arteriovenous malformations after multiple sessions of endovascular treatment.
作者信息
Lessa Silvio Sarmento, Paz-Archilla Juan Alberto, Amorim Bruno Loof, Filho Jose Maria Campos, de Siqueira Campos Christiane Monteiro, de Deus Silva Leonardo, Choque Richard Gonzalo Parraga, da Costa Marcos Devanir Silva, Chaddad-Neto Feres
机构信息
Department of Neurosurgery, Universidade Federal de São Paulo, Brazil.
Department of Radiology, Hospital Beneficencia Portuguesa de São Paulo, Brazil.
出版信息
Surg Neurol Int. 2021 May 10;12:214. doi: 10.25259/SNI_187_2021. eCollection 2021.
BACKGROUND
Arteriovenous malformations (AVMs) are relatively uncommon congenital vascular anomalies, and only 7-15% of AVMs occur in the posterior fossa. Most posterior fossa AVMs clinically present with hemorrhage and are associated with a high risk of neurological deficits and mortality. These malformations are associated with a high incidence of flow-related aneurysms. Endovascular treatment of infratentorial AVMs is challenging in pediatric patients.
CASE DESCRIPTION
We describe an 11-year-old female adolescent with cerebellar syndrome [Video 1], who was diagnosed with a cerebellomesencephalic fissure AVM. We observed a sequential increase in the size of the AVM after multiple sessions of endovascular treatment and performed successful microsurgical resection of the lesion.
CONCLUSION
This illustrative video highlights the role of microsurgery as a feasible therapeutic strategy for complete resection of cerebellar AVMs after endovascular embolization.
背景
动静脉畸形（AVM）是相对罕见的先天性血管异常，仅7%-15%的AVM发生于后颅窝。大多数后颅窝AVM临床上表现为出血，且与神经功能缺损和死亡的高风险相关。这些畸形与血流相关动脉瘤的高发生率有关。小儿患者幕下AVM的血管内治疗具有挑战性。
病例描述
我们描述了一名患有小脑综合征的11岁女性青少年[视频1]，她被诊断为小脑脑桥裂AVM。我们观察到在多次血管内治疗后AVM大小呈序贯性增加，并成功地对该病变进行了显微手术切除。
结论
这段演示视频突出了显微手术作为血管内栓塞后完全切除小脑AVM的一种可行治疗策略的作用。
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