Schijman E, Monges J A
Childs Brain. 1983;10(2):121-9. doi: 10.1159/000120105.
A 3-month-old female infant presented a 20-day history of drowsiness and maturing deterioration. The neurological exam showed peripheric facial palsy on the right side and a brachiocrural hemiparesis on the left. A brain scan revealed a lesion of avascular content in the posterior fossa. The computed tomography scan showed hydrocephalus and a high-density lesion, nonenhanced after introduction of the contrast agent, compatible with a clot at posterior fossa level. Likewise, after contrast new images appeared which had not been seen previously, considered as afferent and efferent vascular elements to the lesion. The cerebral angiography showed an avascular lesion in the cerebellar vermis with important hypertrophy of arterial and venous elements, although no steal phenomena of neighbouring areas was evident. These findings, and the absence of cardiac failure, suggested the diagnosis, confirmed by surgery, of giant clotted arteriovenous malformation. The patient has done well postoperatively.
一名3个月大的女婴出现嗜睡和病情逐渐恶化20天的症状。神经系统检查显示右侧周围性面瘫和左侧臂腿部偏瘫。脑部扫描显示后颅窝有一个无血管成分的病变。计算机断层扫描显示脑积水和一个高密度病变，注入造影剂后未增强，与后颅窝水平的血凝块相符。同样，注入造影剂后出现了之前未见的新图像，被认为是病变的传入和传出血管成分。脑血管造影显示小脑蚓部有一个无血管病变，动脉和静脉成分明显肥大，尽管相邻区域没有明显的盗血现象。这些发现，以及没有心力衰竭，提示诊断为巨大血栓形成的动静脉畸形，手术证实了这一诊断。患者术后恢复良好。
