Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.%目的:探讨儿童期脑动静脉畸形(AVM)破裂出血急性期的确诊方式、显微外科治疗时机与急性期手术治疗效果。方法对2003~2013年收治的72例儿童(≤16岁)AVM出血患者临床资料进行回顾性分析。结果 CT确诊率为48.6%(35/72),MRI确诊率78.3%(47/60)。对条件允许的56例患者行早期全脑脑血管造影(DSA)检查,确诊率为98.2%(55/56)。72例患者均在出血急性期行显微镜下血肿清除及针对性病灶切除术,70例患者术后围术期复查 DSA/CT血管造影(CTA)/磁共振血管造影(MRA),病灶切除率为91.4%,部分切除率为8.6%。围术期死亡2例,70例存活患者中60例(85.7%)患者获得随访6个月至6年,按照 GOS评定:5分55例,4分2例,3 分2例,2分1例。结论 DSA是儿童 AVM出血早期诊断主要的检查手段;急性期显微手术可降低出血病死率和改善预后。
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