Remission of neurovascular conflicts in the cerebellopontine angle in interventional neuroradiology.
Remission of neurovascular conflicts in the cerebellopontine angle in interventional neuroradiology.
复制标题
介入神经放射学中桥小脑角神经血管冲突的缓解。
DOI：
10.1136/neurintsurg-2014-011500
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发表时间：
2014
影响因子：
4.8
通讯作者：
Yang Xinjian
中科院分区：
文献类型：
--
作者：
Li Chuanhui;Li Youxiang;Jiang Chuhan;Wu Zhongxue;Wang Yang;Yang Xinjian
背景与目的探讨血管内治疗（EVT）对颅内动脉瘤（IAs）和颅内动静脉畸形（AVMs）引起的桥小脑角（CPA）神经血管冲突（NVC）的疗效，包括三叉神经痛、面肌痉挛和舌咽神经痛。 方法2010年1月至2014年1月，我科连续收治14例因IAA或颅内AVM引起的3次NVC患者。回顾性分析EVT后这些NVC的临床结果。结果对于4例IAA患者，血管造影随访证实病灶全部闭塞，NVC的临床结果如下：2例（50%）逐渐缓解，1例（25%）短暂部分缓解但复发，1例（25%）无姑息效果。 10 例颅内 AVM 患者中，1 例（10%）在血管造影检查后出现 NVC 短暂缓解（未进行 EVT）。在接受 EVT 的其他 9 名患者中，7 名 (70%) 患者进行了血管造影随访，结果显示 3 名 (30%) 患者病变完全闭塞，2 名 (20%) 患者部分完全闭塞，2 名 (20%) 患者部分闭塞。临床结果包括 2 例（20%）在单次 EVT 后 NVC 立即缓解，5 例（50%，其中 1 例经历短暂加重）在单次 EVT 后逐渐缓解，2 例（20%）在两次 EVT 后完全缓解。颅内 AVM 病例中 2 例（20%）发生与 EVT 相关的短暂性颅神经麻痹并发症。总共有 11 例（78.6%）最终获得了 NVC 的完全持久缓解。结论 EVT 是缓解 IA 或颅内 AVM 引起的 CPA 内 NVC 的一种可行且侵入性较小的方法，可被视为这些情况的治疗选择。
Background and purposeTo investigate the efficacy of endovascular treatment (EVT) for neurovascular conflicts (NVCs) in the cerebellopontine angle (CPA) caused by intracranial aneurysms (IAs) and intracranial arteriovenous malformations (AVMs), including trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia.Materials and methodsFrom January 2010 to January 2014, 14 consecutive patients presenting with three NVCs caused by IAs or intracranial AVMs were admitted to our department. The clinical outcomes of these NVCs after EVT were retrospectively analyzed.ResultsFor four patients with IAs, angiographic follow-up confirmed total occlusion of the lesion in all, and the clinical outcomes of NVC were as follows: gradual relief in two (50%), transient partial relief but recurrence in one (25%), and no palliative effect in one (25%). For the 10 patients with intracranial AVMs, one (10%) experienced transient relief of NVC after angiogram examination (no EVT was performed). Of the other nine patients who received EVT, angiographic follow-up was obtained in seven (70%), demonstrating total obliteration of the lesion in three (30%), subtotal obliteration in two (20%), and partial obliteration in two (20%). Clinical outcomes included immediate relief of NVCs after single EVT in two cases (20%), gradual relief after single EVT in five (50%, one of them experienced transient aggravation), and complete relief after two sessions of EVT in two (20%). Complications of transient cranial nerve paresis related to EVT occurred in two cases (20%) with intracranial AVMs. In all, complete lasting relief of the NVCs was obtained finally in 11 cases (78.6%).ConclusionsEVT is a feasible and less invasive approach for relief of NVCs in the CPA caused by IA or intracranial AVM and could be considered as a therapeutic option in these situations.