前颅底硬脑膜动静脉瘘的诊断与治疗（附26例报告）

Q4 Medicine

中华神经外科杂志 Pub Date : 2019-11-28 DOI:10.3760/CMA.J.ISSN.1001-2346.2019.11.009

Hui Luo, Qianmiao Zhu, Xiefeng Wang, W. Yan, Rui Li

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引用次数: 0

摘要

目的探讨前颅底硬脑膜动静脉瘘的诊断和治疗方法。方法回顾性分析南京医科大学第一附属医院神经外科2011年1月至2019年1月收治的26例前颅底DAVFs患者的临床资料。所有患者均采用额下入路进行手术。重点介绍了其临床表现、影像学特点及手术方法。术后及随访期间采用数字减影血管造影术（DSA）评价疗效。结果26例患者瘘管均成功闭合。2例患者出现嗅觉缺失，无其他严重并发症发生。术后DSA证实DAVFs完全闭塞，随访3个月至9年未观察到复发。结论DSA是诊断前颅底DAVFs的有效方法，显微外科瘘管闭合术是治疗前颅底DAWFs的有效手段。充分的术前影像学评估、熟练的显微外科技术、准确的瘘管闭合是手术成功的关键。关键词：动静脉瘘；颅底；诊断；治疗；杜拉尔

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Diagnosis and treatment of anterior skull base dural arteriovenous fistulas: A report of 26 cases

Objective To investigate the diagnosis and treatment of dural arteriovenous fistulas (DAVFs) of anterior skull base. Methods The clinical data of 26 patients with DAVFs of anterior skull base admitted to Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from January 2011 to January 2019 were studied retrospectively. All the patients underwent operation through subfrontal approach. We focused on their clinical manifestations, imaging features and surgical methods. The therapeutic effects were evaluated by digital subtraction angiography (DSA) after operation and during follow-up. Results The fistulas of all 26 patients were successfully closed. Anosmia was reported in 2 cases and no other serious complications occurred. The complete obliteration of DAVFs was confirmed by postoperative DSA, and no recurrence was observed at follow-up ranging from 3 months to 9 years. Conclusion DSA seems to be an effective method for the diagnosis of anterior skull base DAVFs, for which microsurgical closure of fistulas is the effective treatment. Sufficient preoperative imaging evaluation, skilled microsurgical techniques, exact closure of fistulas are keynotes for the success of operation. Key words: Arteriovenous fistula; Skull base; Diagnosis; Treatment; Dural

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.