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目的 探讨临床特点、CT、MRI和显微外科在诊断青少年隐匿性脑血管畸形 (AOVM )中的价值。方法 对首发症状为头痛、呕吐、意识障碍 15例 ,抽搐发作伴偏头痛 7例 ,肢体运动及感觉障碍 3例 ,且脑动脉数字减影血管造影 (DSA)为阴性的 2 5例青少年做了CT、MRI检查。CT平扫 15例为颅内血肿 ,10例显示混合密度(2例有钙化 ) ,6例增强扫描可见异常血管强化。MRI分别显示环形低信号区围绕斑片状高低混合信号灶或单纯高信号。结果 全部病例均经显微外科治疗 ,9例术中在血肿壁上或与脑组织交界处可见异常小血管。病理结果 :17例动静脉畸形 ,8例海绵状血管瘤。结论 CT、MRI可对AOVM作出诊断或提示性诊断 ,MRI优于CT ,临床特点可作为参考诊断 ,显微外科 (包括病理检查 )则是最佳确诊与治疗方法
Objective To investigate the clinical features, CT, MRI and microsurgery in the diagnosis of adolescent occult cerebrovascular malformation (AOVM) value. Methods Twenty-five adolescents with headache, vomiting, disturbance of consciousness, convulsive seizures with migraine in 7, limb movement and sensory disturbances in 3 patients, and negative brain angiography with digital subtraction angiography (DSA) CT, MRI examination. CT scan of 15 cases of intracranial hematoma, 10 cases showed mixed density (calcification of 2 cases), 6 cases of enhanced scanning showed abnormal vessel enhancement. MRI showed ring-shaped low signal area around the patchy level of mixed-signal stove or simple high signal. Results All cases were treated by microsurgery. Nine cases showed abnormal small blood vessels on the wall of hematoma or junction with brain tissue. Pathological results: 17 cases of arteriovenous malformations, 8 cases of cavernous hemangioma. Conclusion CT and MRI can make diagnosis or suggestive diagnosis of AOVM. MRI is superior to CT. The clinical features can be used as a reference diagnosis. Microsurgery (including pathological examination) is the best method of diagnosis and treatment