Radek A, Maciejczak A, Zajgner J, Duda W, Piwowarski W, Kochanowski J, Jarmundowicz W, Harat M, Rynkiewicz T
Kliniki Neurochirurgii Wojskowej Akademii Medycznej w Lodzi.
Neurol Neurochir Pol. 1996 Mar-Apr;30(2):333-45.
The authors present two cases of inoperable AVM's of thoracic spinal cord successfully treated by embolization with histoacryl glue (B. Brown Melsungen AG). The glue used for embolization is characterized by instant polymerization when comes in contact with blood. A mass of polymer is visible on X-ray thanks to contrast medium Lipiodol and metallic powder Tungsten that are added to glue and injected together with the latter. In the first case, a female who presented with paraparesis and walked only with assistance embolization performed in one session resulted in neurological improvement enabling independent walking at follow-up 2 yrs later. In the second case of a young male not walking for severe paraparesis embolization performed in three sessions resulted in significant neurological recovery. 10 days after the first session the patient became ambulatory. 6 months after treatment he presented with mild paraparesis and was still ambulatory and leading independent life. In each case embolization was performed after balloon occlusion test during which the function of spinal cord was monitored by somatosensory evoked potentials and neurological assessment.
作者介绍了两例无法手术的胸段脊髓动静脉畸形(AVM),通过使用 Histoacryl 胶水(B. Brown Melsungen AG)进行栓塞成功治疗。用于栓塞的胶水的特点是与血液接触时会立即聚合。由于添加到胶水中并与胶水一起注射的造影剂碘油和金属粉末钨,在 X 射线下可见一团聚合物。在第一例中,一名女性患者表现为双下肢轻瘫,仅在他人协助下才能行走,一次栓塞治疗后神经功能得到改善,2 年后随访时能够独立行走。在第二例中,一名年轻男性因严重双下肢轻瘫而无法行走,分三次进行栓塞治疗后神经功能显著恢复。第一次治疗后 10 天患者能够行走。治疗 6 个月后,他仍有轻度双下肢轻瘫,但仍能行走并独立生活。在每例中,均在球囊闭塞试验后进行栓塞,在此期间通过体感诱发电位和神经功能评估监测脊髓功能。