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中华脑血管病杂志(电子版) ›› 2023, Vol. 17 ›› Issue (03) : 294 -296. doi: 10.11817/j.issn.1673-9248.2023.03.018

病例报告

颅颈交界区硬脊膜动静脉瘘一例
吴峣, 沈胜利, 许菲璠, 张家湧, 段鸿洲(), 李良   
  1. 100034 北京大学第一医院神经外科
  • 收稿日期:2022-09-03 出版日期:2023-06-01
  • 通信作者: 段鸿洲
  • 基金资助:
    中华国际医学交流基金(LJS-2020B3); 北京大学第一医院青年临床研究专项基金(2019CR02)

Craniocervical junction dural arteriovenous fistula: case report

Yao Wu, Shengli Shen, Feipan Xu   

  • Received:2022-09-03 Published:2023-06-01
引用本文:

吴峣, 沈胜利, 许菲璠, 张家湧, 段鸿洲, 李良. 颅颈交界区硬脊膜动静脉瘘一例[J]. 中华脑血管病杂志(电子版), 2023, 17(03): 294-296.

Yao Wu, Shengli Shen, Feipan Xu. Craniocervical junction dural arteriovenous fistula: case report[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(03): 294-296.

图1 硬脊膜动静脉瘘患者影像学检查及手术图。图a 患者入院前颈椎MRI矢状位T2 加权像显示延髓、颈髓及上胸髓髓内水肿明显(箭头处);图b 患者入院后药物治疗2 周,颈椎MRI矢状位T2 加权像显示脊髓水肿加重,脊髓表面似可见较多迂曲虫噬样血管流空影;图c 脊髓血管造影显示颅颈交界区硬脊膜动静脉瘘,箭头处为瘘口部位;图d 为硬脊膜动静脉瘘血管构筑示意图,箭头处为瘘口部位;图e 显微镜下可见颅颈交界区复杂迂曲血管团;图f 为术中荧光造影,确认瘘口及粗大引流静脉,箭头可见脊髓腹侧粗大静脉在动脉期快速充盈;图g 示分离瘘口及靠近瘘口的引流静脉近端,并以动脉瘤夹临时夹闭,再行荧光造影,箭头显示脊髓腹侧粗大引流静脉显影消失;图h 术后1 个月复查颈椎MRI 显示颈髓水肿明显减轻(箭头),异常迂曲血管影消失
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