Morita A, Meyer F B, Nichols D A, Patterson M C
Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Neurosurgery. 1995 Dec;37(6):1193-9; discussion 1199-200. doi: 10.1227/00006123-199512000-00020.
We report three cases of posterior dural sinus arteriovenous fistulae in pediatric patients and a literature review of 18 additional cases. These lesions carry a grave prognosis with a reported mortality of 38% and with an historical anatomic cure of only approximately 9%. With advanced neurointerventional techniques and increased knowledge of their pathophysiology, these highly complicated lesions can be more safely treated with a strategy that involves extensive preoperative embolization and surgical excision. The importance of delaying direct surgery with conservative measures or interventional radiological treatment, including preoperative transarterial and transvenous embolization, is critical in the management of these lesions.
我们报告了3例小儿患者的后硬脑膜窦动静脉瘘病例,并对另外18例病例进行了文献综述。这些病变预后严重,报告的死亡率为38%,历史上解剖学治愈率仅约为9%。随着先进的神经介入技术以及对其病理生理学认识的增加,这些高度复杂的病变可以通过一种包括广泛术前栓塞和手术切除的策略更安全地进行治疗。在这些病变的管理中,采用保守措施或介入放射治疗(包括术前经动脉和经静脉栓塞)延迟直接手术至关重要。