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影像学表现为颅颈交界区动静脉瘘合并脑干占位性病变1例:病例报告及文献复习

A Case of Craniocervical Junction Arteriovenous Fistulas with a Brainstem Mass Lesion on Imaging: Case Report and Literature Review.

作者信息

Peng Zheng, Wang Yunfeng, Pang Cong, Li Xiaojian, Zhuang Zong, Li Wei, Hang Chunhua

机构信息

Department of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210029, China.

Neurosurgical Institute, Nanjing University, Nanjing 210029, China.

出版信息

Brain Sci. 2023 May 22;13(5):839. doi: 10.3390/brainsci13050839.

Abstract

Intracranial mass lesions occur within the cranial cavity, and their etiology is diverse. Although tumors and hemorrhagic diseases are the common causes, some rarer etiologies, such as vascular malformations, might also present with intracranial mass lesion manifestations. Such lesions are easily misdiagnosed due to the lack of manifestations of the primary disease. The treatment involves a detailed examination and differential diagnosis of the etiology and clinical manifestations. On 26 October 2022, a patient with craniocervical junction arteriovenous fistulas (CCJAVFs) was admitted to Nanjing Drum Tower Hospital. Imaging examinations showed a brainstem mass lesion, and the patient was initially diagnosed with a brainstem tumor. After a thorough preoperative discussion and a digital subtraction angiography (DSA) examination, the patient was diagnosed with CCJAVF. The patient was cured using interventional treatment, and an invasive craniotomy was not required. During diagnosis and treatment, the cause of the disease might not be apparent. Thus, a comprehensive preoperative examination is very important, and physicians need to conduct the diagnosis and differential diagnosis of the etiology based on the examination to administer precise treatment and reduce unnecessary operations.

摘要

颅内占位性病变发生于颅腔内,其病因多种多样。虽然肿瘤和出血性疾病是常见病因,但一些较罕见的病因,如血管畸形,也可能表现为颅内占位性病变的症状。由于缺乏原发性疾病的表现,此类病变很容易被误诊。治疗需要对病因和临床表现进行详细检查及鉴别诊断。2022年10月26日,一名患有颅颈交界区动静脉瘘(CCJAVF)的患者入住南京鼓楼医院。影像学检查显示脑干有占位性病变,该患者最初被诊断为脑干肿瘤。经过全面的术前讨论和数字减影血管造影(DSA)检查后,该患者被诊断为CCJAVF。患者通过介入治疗得以治愈,无需进行侵入性开颅手术。在诊断和治疗过程中,疾病的病因可能并不明显。因此,全面的术前检查非常重要,医生需要根据检查结果对病因进行诊断和鉴别诊断,以便进行精准治疗并减少不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49eb/10216339/81cfe97d2c8c/brainsci-13-00839-g001.jpg

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