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大脑动静脉畸形几乎完全消退——病例报告(作者译)

[Almost complete regression of cerebral arteriovenous malformation--report of a case (author's transl)].

作者信息

Sasaki U, Itagaki T, Shimizu H, Takahashi M

出版信息

No Shinkei Geka. 1976 Feb;4(2):175-81.

PMID:943724
Abstract

Spontaneous regression or disappearance of cerebral arteriovenous malformation (AVM) had been rarely reported in the literatures. Regression after carotid ligation or radiation therapy are not spontaneous one, because these treatments may have some influences on morphological changes of AVM by CBF dynamic change or by some radiobiological effects on AVM. The reported case is 57 aged male. He had an episode of sudden onset of left hemiparesis 7 years ago and was treated conservatively at a private doctor. Afterward he enjoyed his life, for 4 years, he consulted our clinic on account of left hemiconvulsion. Right CAG revealed right parietal AVM (3.5 X 4.0 X 5.O) with dilated feeding and draining vessels. Patient denyed operation at that time, but again consulted our clinic on account of severe left hemiconvulsion. Right CAG was performed again, but right parietal AVM was almost not visualized and feeding and draining vessels were diminished in diameter. Inspite of repeated 4 vessel angiographies AVM was remarkably regressed, and also no angiospastic vessels and intracerebral hematoma were absent in these angiographies. Though spontaneous regression of cerebral AVM is rare course, we report the importance of morphological follow up, when cerebral AVM is nondefinitively treated.

摘要

脑动静脉畸形(AVM)的自发消退或消失在文献中鲜有报道。颈动脉结扎或放射治疗后的消退并非自发的,因为这些治疗可能通过脑血流量动态变化或对AVM的某些放射生物学效应,对AVM的形态变化产生一些影响。报告的病例为一名57岁男性。他7年前曾突发左侧偏瘫,在一名私人医生处接受了保守治疗。此后他生活正常,4年后因左侧半身惊厥到我们诊所就诊。右侧脑血管造影(CAG)显示右侧顶叶AVM(3.5×4.0×5.0),供血和引流血管扩张。患者当时拒绝手术,但因严重的左侧半身惊厥再次到我们诊所就诊。再次进行右侧CAG检查时,右侧顶叶AVM几乎未显影,供血和引流血管直径减小。尽管进行了4次血管造影,AVM仍显著消退,且这些血管造影中也未发现血管痉挛和脑内血肿。虽然脑AVM的自发消退是罕见的过程,但我们报告了在脑AVM未得到明确治疗时进行形态学随访的重要性。

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