Thajeb P, Hsi M S
Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Angiology. 1987 Nov;38(11):851-8. doi: 10.1177/000331978703801108.
The authors studied 136 Chinese patients with verified cerebral arteriovenous malformations (AVMs) in Taiwan. Intracranial hemorrhage (ICH) was the leading problem at presentation (83.8%), followed by epileptic seizures (21.3%) and vascular headache alone (9.6%). Patients less than forty years old and/or with small AVMs (less than 20 ml) had a statistically significantly higher risk of bleeding (P less than 0.01 and P less than 0.05 respectively). The risk of rebleeding remained unchanged in both small (less than 20 ml) and large (greater than or equal to 20 ml) AVMs once ICH had occurred. The average annual bleeding rate of a nonbleed AVM with seizure alone was 1.7%. Seizures with a partial component could be identified in less than half of the epileptic patients, and EEG abnormalities were found in 85.7% of 45 studied cases. The difference in mortality between medically and surgically treated patients was not of statistical significance. The numbers for both morbidity and good recovery were higher in the surgical group. The rationale for selection of surgical cases is discussed.
作者对台湾136例经证实患有脑动静脉畸形（AVM）的中国患者进行了研究。颅内出血（ICH）是就诊时的主要问题（83.8%），其次是癫痫发作（21.3%）和单纯血管性头痛（9.6%）。年龄小于40岁和/或患有小AVM（小于20毫升）的患者出血风险在统计学上显著更高（分别为P<0.01和P<0.05）。一旦发生ICH，小（小于20毫升）和大（大于或等于20毫升）AVM的再出血风险均保持不变。单纯有癫痫发作的未出血AVM的年平均出血率为1.7%。在不到一半的癫痫患者中可发现有部分性成分的癫痫发作，在45例研究病例中有85.7%发现脑电图异常。药物治疗和手术治疗患者的死亡率差异无统计学意义。手术组的发病率和良好恢复率均更高。文中讨论了手术病例选择的理由。
