基底节区小型动静脉畸形出血的手术治疗

摘要

Objective To study the operative treatment of small cerebral arteriovenous malformations (AVMs) with intracerebral hematomal in basal ganglia. Method 32 cases with basal ganglia hemorrhage were confirmed by preoperative computerized tomography (CT). All of them recieved hematoma debridement plus AVM excision. Results After operation, questionable abnormal blood vessel was underwent pathological section and confirmed for cerebral arteriovenous malformations (AVMs). No AVMs were found in the postoperative MRI and MRA. Follow up after 3 months, 7 cases in ADL Ⅰ ; 17 cases in ADL Ⅱ ; 8 cases in ADL Ⅲ ; No lying in bed cases and plant man; no rehaemorrhagia cases after operation. Conclusion Hematoma debridement plus AVM excision to treat the patients who have the small cerebral arteriovenous malformations (AVMs) with intracerebral hematomal in basal ganglia can decrease rehaemorrhagia occurrence and receive better prognosis.%目的 探讨基底节区小型动静脉畸形出血并脑内血肿病人的手术治疗问题.方法 32例CT示基底节区脑出血患者术中均行血肿清除和血管畸形切除.结果 术后对切除的可疑畸形血管行病理切片检查,均证实为脑动静脉畸形.术后MRI及MRA检查均未见脑血管畸形.术后3个月随访ADL分级,Ⅰ级完全恢复日常生活7例;Ⅱ级部分恢复或可独立生活17例;Ⅲ级需他人帮助,扶拐可行8例;无卧床,植物生存病人;无术后再出血患者.结论 基底节区小型动静脉畸形出血并脑内血肿病人行血肿清除和畸形血管切除可减少再出血发生,取得了较好预后.