脑动静脉畸形

文摘

脑动静脉畸形(avm)异常脑动脉和静脉之间的直接分流术,渐渐康复血管病灶。avm的治疗策略是具有挑战性和变量。颅内出血、癫痫占avm的最常见的演讲。然而,偶然的avm被诊断出患有因广泛使用非侵入性神经影像越来越频繁。估计累积一生出血风险之间的平衡和干预的风险往往是治疗的主要决定因素。当前管理选项包括手术切除、栓塞、立体定向放射外科(SRS),观察。完整的尼达尔的目标是消灭AVM的干预。干预的风险和利益是不同的,可用于组合的方式。AVM病灶的切除提供高水平的直接删除,但它是侵入性和温和的神经发病的风险。动静脉栓塞是微创,但治疗只能在少数的病变。 SRS is also minimally invasive and has little immediate morbidity, but AVM obliteration occurs in a delayed fashion, so the patient remains at risk of hemorrhage during the latency period. Whether obliteration can be achieved in unruptured AVMs with a lower risk of stroke or death compared with the natural history of AVMs remains controversial. Over the past 5 years, multicenter prospective and retrospective studies describing AVM natural history and treatment outcomes have been published. This review provides a contemporary and comprehensive discussion of the natural history, pathobiology, and interventions for brain AVMs.