Ramos Gabriel A, Dabhi Nisha, Brandt M Todd, Park Min S
Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia.
Blue Ridge Oral and Maxillofacial Surgery, Fishersville, Virginia.
J Neurosurg Case Lessons. 2025 Apr 21;9(16). doi: 10.3171/CASE24868.
Primary intraosseous arteriovenous malformations (AVMs) are rare, especially as intraosseous lesions in the mandible. Resection, with or without embolization, has historically been the treatment of choice. There are few reports in the literature regarding the treatment of these lesions with primary sclerotherapy.
A 13-year-old female presented with significant bleeding from a progressively enlarging alveolar and gingival mass with loosening dentition following a biopsy of a left mandibular lesion. CT angiography of the head diagnosed bilateral Schöbinger stage II intramandibular AVMs. She underwent sclerotherapy using ethanol and coils for both lesions in separate sessions as the primary treatment of the lesions. Posttreatment, the patient showed no complications or recurrence, and her dentition settled into normal occlusion without mobility.
Primary sclerotherapy using ethanol and coils can be an effective treatment option for low-stage, simple intraosseous AVMs. Further studies are needed to determine the optimal interventional treatment for intraosseous AVMs and to compare the efficacy of different sclerosants. https://thejns.org/doi/10.3171/CASE24868.
原发性骨内动静脉畸形（AVM）较为罕见，尤其是作为下颌骨内的病变。无论是否进行栓塞，手术切除一直是首选的治疗方法。关于采用原发性硬化疗法治疗这些病变的文献报道很少。
一名13岁女性，在对左侧下颌骨病变进行活检后，出现了一个逐渐增大的牙槽和牙龈肿物大量出血，伴有牙列松动。头部CT血管造影诊断为双侧Schöbinger II期下颌骨内AVM。她接受了硬化疗法，在不同的疗程中分别使用乙醇和弹簧圈对两个病变进行治疗，作为病变的主要治疗方法。治疗后，患者未出现并发症或复发，她的牙列恢复到正常咬合，没有松动。
使用乙醇和弹簧圈的原发性硬化疗法对于低分期、简单的骨内AVM可能是一种有效的治疗选择。需要进一步研究以确定骨内AVM的最佳介入治疗方法，并比较不同硬化剂的疗效。https://thejns.org/doi/10.3171/CASE24868 。
