Meisel H J, Lasjaunias P, Brock M
Department of Neurosurgery, Klinikum Steglitz, Free University of Berlin, Germany.
Neuroradiology. 1996 Jul;38(5):490-3. doi: 10.1007/BF00607286.
We report long-term follow-up of a rare multiple arteriovenous malformation of the spinal cord in a 15-year-old patient. A significant reduction in the size of the lesion was achieved by microsurgical resection of the dorsal and lateral portions. This eliminated the initial source of subarachnoid haemorrhage, and the patient's condition remained stable for 10 years. Renewed angiography of the residual ventrolateral malformation became necessary after recurrent subarachnoid haemorrhage, and the centre of the malformation was embolised selectively with bucrylate. Following embolisation, prophylactic treatment with steroids and heparin led to rapid improvement of the pre-embolisation symptoms. Our observations indicate that venous flow in the spinal cord is highly sensitive to haemodynamic changes. The angioarchitecture was indicative of multifocal arteriovenous shunts, an extremely rare condition, and the question arises whether these shunts were acquired or congenital.
我们报告了一名15岁患者罕见的脊髓多发性动静脉畸形的长期随访情况。通过显微手术切除背侧和外侧部分，病变大小显著缩小。这消除了蛛网膜下腔出血的初始来源，患者病情保持稳定达10年。在复发性蛛网膜下腔出血后，有必要对残留的腹外侧畸形进行再次血管造影，并使用丁苯羟酸对畸形中心进行选择性栓塞。栓塞后，使用类固醇和肝素进行预防性治疗，使栓塞前症状迅速改善。我们的观察表明，脊髓中的静脉血流对血流动力学变化高度敏感。血管结构显示为多灶性动静脉分流，这是一种极其罕见的情况，并且出现了这些分流是后天获得性还是先天性的问题。
