Takahashi S, Furuhashi N, Koshu K
No Shinkei Geka. 1977 Jul;5(8):889-93.
Congenital arteriovenous malformation of the extracranial region is rare. The case presented here is a woman aged 29. She gave a history of swelling of the scalp at the left temporat region and noticed a rhythmic pulsating noise in the left ear of five mon ths duration, especially when she placed that side of her head against a pillow. Physical examination revealed a pulsating compressible tumor mass measuring 10 cmx8cm in the left temporal area of the head. There was a bruit synchronous with the pulse and an associated thrill over the mass. A left external carotid angiogram demonstrated that the deep temporat branches of the marked dilated internal maxillary artery as well as the branch of the superficial temporal artery fed the arteriovenous malformation at the extracranial region. Venous drainage to the superficial temporal vein and the maxillary vein were present. Multiple arteriovenous fistulas and persistent pooling of contrast medium were noted. At operation. At operation, the left external carotid artery was ligated and the malformation was excised. The postoperative course was entirely uncomplicated. The bruit disappeared and she was discharged on the 12th postoperative day. Histologically, the arteriovenous malformation was demonstrated. We reviewed the literatures and discussed the etiology, clinical and roentgraphic findings of the congenital arteriovenous malformation at the extracranial region.
先天性颅外动静脉畸形较为罕见。本文报道的病例为一名29岁女性。她有左侧颞部头皮肿胀的病史，并注意到左耳有节奏的搏动性杂音，持续了五个月，尤其是当她将头部的那一侧靠在枕头上时。体格检查发现头部左侧颞区有一个搏动性、可压缩的肿瘤肿块，大小为10 cm×8cm。肿块上有与脉搏同步的杂音及相关震颤。左侧颈外动脉血管造影显示，明显扩张的上颌内动脉的颞深支以及颞浅动脉的分支为颅外动静脉畸形供血。存在向颞浅静脉和上颌静脉的静脉引流。可见多个动静脉瘘及造影剂持续潴留。手术中，结扎了左侧颈外动脉并切除了畸形。术后过程完全无并发症。杂音消失，她在术后第12天出院。组织学检查证实为动静脉畸形。我们复习了文献并讨论了先天性颅外动静脉畸形的病因、临床及影像学表现。
