Multiple dural arteriovenous fistulas of the cranium and spine.
Multiple dural arteriovenous fistulas of the cranium and spine.
复制标题
颅骨和脊柱多发硬脑膜动静脉瘘。
DOI：
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发表时间：
1991
期刊：
影响因子：
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通讯作者：
C. Wilson
中科院分区：
文献类型：
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作者：
S. Barnwell;V. Halbach;C. Dowd;R. Higashida;G. Hieshima;C. Wilson
硬脑膜动静脉瘘是获得性病变，通常累及海绵窦周围的硬脑膜。横窦、乙状窦和上矢状窦偶尔可能受到影响。除双侧海绵窦硬脑膜动静脉瘘外，两处同时发生硬脑膜动静脉瘘的情况很少见。在 105 名接受硬脑膜动静脉瘘评估的患者中，我们发现 7 名患者的两个部位有瘘管。患者年龄从27岁到74岁不等。三名患者的症状与出血有关，四名患者视力丧失，一名患者有杂音和头痛。患者接受手术和血管内技术相结合的治疗。所有治疗的病灶均完全闭合，无死亡或永久性发病情况。在接受硬脑膜动静脉瘘评估的患者中，必须考虑到多发性瘘管的存在。多发性瘘管患者通常会出现危及生命的出血或急性神经功能衰退；多发性硬脑膜动静脉瘘患者发生出血的危险因素很高，包括与静脉流出道梗阻相关的出血。
Dural arteriovenous fistulas are acquired lesions that usually involve the dura around the cavernous sinus. The transverse, sigmoid, and superior sagittal sinuses may be affected occasionally. With the exception of bilateral cavernous sinus dural arteriovenous fistulas, the simultaneous occurrence of dural arteriovenous fistulas at two locations is rare. Among 105 patients evaluated for dural arteriovenous fistulas, we identified seven patients with fistulas at two sites. The age of the patients ranged from 27 to 74 years. Presentation was related to hemorrhage in three patients, loss of vision in four, and a bruit and headaches in one. Patients were treated with combined surgical and endovascular techniques. All treated lesions were completely closed with no mortality or permanent morbidity. The presence of multiple fistulas must be considered in patients being evaluated for dural arteriovenous fistulas. Patients with multiple fistulas usually present with life-threatening hemorrhages or acute neurologic decline; the risk factor for hemorrhages, including those related to venous outflow obstruction, is high in patients with multiple dural arteriovenous fistulas.