Nakau H, Maruishi M, Takiguchi H, Shima K
Department of Neurosurgery, National Defense Medical College, Tokorozawa, Japan.
Neurosurgery. 1998 Dec;43(6):1459-61; discussion 1461-2. doi: 10.1097/00006123-199812000-00117.
This is the first reported case of the successful surgical removal of a large arteriovenous malformation (AVM) in a patient with hemophilia A.
A 19-year-old male patient was admitted to our department with intracranial hemorrhage. He had previously been diagnosed with hemophilia A and a cerebral AVM. Carotid angiography revealed a large AVM in the right temporal and parietal lobes. The neurological and neuroradiological findings, especially those of single photon emission computed tomography, identified an area of devitalization around the lesion, which was thought to reduce the risk of new deficits resulting from surgical manipulation.
We resected the AVM in conjunction with supplemental infusions of Factor VIII before, during, and after the operation. A slight cerebral hemorrhage on the 7th postoperative day was observed despite control with Factor VIII, but the patient was discharged without any new deficits.
We evaluated and managed all problems of a patient with multiple complications and achieved a medical cure.
这是首例成功手术切除甲型血友病患者大型动静脉畸形（AVM）的报道病例。
一名19岁男性患者因颅内出血入住我科。他此前被诊断为甲型血友病和脑动静脉畸形。颈动脉血管造影显示右侧颞叶和顶叶有一个大型动静脉畸形。神经学和神经放射学检查结果，尤其是单光子发射计算机断层扫描结果，确定了病变周围有一个失活区域，这被认为可降低手术操作导致新的神经功能缺损的风险。
我们在手术前、手术期间和手术后联合补充输注凝血因子VIII切除了动静脉畸形。尽管使用凝血因子VIII进行了控制，但术后第7天仍观察到轻微脑出血，但患者出院时没有出现任何新的神经功能缺损。
我们评估并处理了一名患有多种并发症患者的所有问题，并实现了治愈。
