뇌경막동정맥기형 환자의 임상적 특성
Clinical Characteristics of Cerebral Dural Arteriovenous Malformations
소속 상세정보
권오기/O Ki Kwon
한대희/오창완/한문희/정영섭/왕규창/조병규/Dae Hee Han/Chang Wan Oh/Moon Hee Han/Young Sub Jung/Kyu Chagn Wang/Byung Kyu Cho
KMID : 0359819980270020186
Abstract
결론
경막동정맥기형의 빈도는 외국의 보고와 유사하였으나 발생 위치는 큰 차이가 있어서 해
면정맥동 경막동정맥기형이 가장 많았다. 여자가 남자보다 많았으나 큰 차이를 보이지는 않
았고 발생 연령은 유아에서부터 고 연령까지 다양하였으며 40∼50대에 가장 호발하였다. 약
반수에서 정맥동의 협착이 동반되었다. 주된 증상은 위치와 정맥유출 양상에 따라 차이가
있으나 안구 돌출 결막 충혈 이명이었다. 이들 중 해면정맥동 경막동정맥기형 환자 2명이
실명하였고, 횡정맥동 경막동정맥기형 환자 1명은 출혈로 사망하였으며 해면정맥동 경막동
정맥기형 환자 1명은 색전술 중 발생한 출혈로 사망하였다. 출혈 발생의 주된 요인은 두개
강내 정맥 유출이었으며 횡정맥동 경막동정맥기형에서 많이 관찰되었다 대부분의 환자에게
혈관내 치료가 시행됐으며 고정된 신경학적 결손이 발생하기 전에 치료한 경우 대부분 예후
가 좋았다 혈관내 치료 중 특히 해면정맥동 경막동정맥기형은 불완전한 폐색술도 치료 효과
가 있는 것이 확인되었다.
#초록#
Intracranial dural arteriovenous malfomation(AVM) is an uncommon neurosurgical
condition ; in particular, it has been infrequently reported in Korea. To understand the
general clinical characteristics of dural AVMs, the authors reviewed 41 cases and
analysed the factors affecting hemorrhage of dural AVMs. Since 1980 we have
encountered 320 pial and 41 dural AVM, a ratio of 7.8 to 1. The age of these patients
ranged from 3 months to 70 years, the most common being the 6th decade, and female
exceeded males by a ratio of 1.56 to 1. All lesions expect on was single, and symptoms
were related to it's location and the venous drainage pattern. The most common location
was the cavernous sinus, according for about 70% of cases, so the most common
clinical symptoms of dural AVMs were ocular, namely- proptosis and chemosis. The
next was tinnitus found in transverse/sigmoid sinus dural AVMs, and this was so even
where there was intracranial venous drainage9p<0.001). However two of 28 patients with
cavernous dural AVMs became blind in one eye, demonstrating that in such patients,
the clinical course could be aggressive. The majority of cases were treated by
endovascular therapy ; surgical excision was performed in only one patient with tentorial
dural AVM. Eight patients were treated conservatively. Three died of hemorrhage, 3
who had had fixed deficit had neurologic deficits even after a definitive treatment, and
35(85%) showed clinical improvement. During intervation, there was one complication,
due to obstruction of venous outflow with embolic materials
키워드
Dural arteriovenous malformation; Symptoms; Treatment;
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