【摘要】 报道从１９９２年２月至１９９３年４月，血管内栓塞治疗脑动静脉畸形（ＡＶＭ）３３例的经验，首发症状以脑出血或蛛网膜下腔出血者１５例，以癫痫发作者１２例，以进行性神经功能障碍３例，以头痛起病者３例。按Ｓｐｅｔｚｌｅｒ分级标准属于Ⅱ级者４例，Ⅲ级者１３例，Ⅳ级者９例，Ⅴ级者７例，无Ⅰ级和Ⅵ级者。采用的栓塞剂有单纯真丝线段混悬液、ＩＢＣＡ、ＰＶＡ或乙醇和乙烯雌酚、微弹簧圈联合栓塞剂。ＡＶＭ病灶完全被栓塞者１６例，占４９％；栓塞７５％以上者８例，占２４％；栓塞５０％～７５％者４例占１２％；栓塞＜５０％者５例占１５％。栓塞后有１例因基底动脉痉挛而死亡，有３例表现为一过性神经功能障碍。文内重点讨论了有关栓塞剂的选择、并发症的防治和正常灌注压突破综合症的预防与治疗。更多还原

【Abstract】 From Fibruary, 1992 to April 1993, 33 intracranial AVM were treated at our institution, 15 patients presented with SAH or intracerebral hematoma, 12 with seizurse, 3 with progressive neurological deficit, 3 with moderate headche.According to Spetzler’s classification, 4 patients were Grade Ⅱ, 13 as Grade Ⅲ, 9 as Grade Ⅳ,7 as Grade Ⅴ, none as GradeⅠand Ⅵ.We used silk segments,IBCA, PVA, ethanol or estrogen and microcoil as embolic agents.Complete occlusion of AVM nidus were obtained in 16 patients(48.5%),obliterated more than 75%of AVM were achieved in 8(24.2%),50%to 75%of AVMs were obliterated in 4(12.1%), obliterated less than 50%of AVMs in 5 (15.2%). After embolization,3 patients appeared with transient neurological deficit (9%) 1 patient died of vasospasm of the basilar artery.In this article, the selection of various embolic agent, prevention and treatment of complications and NPPB are discussed.更多还原