手術で治療困難な脳動静脈奇形

• 菊田 健一郎

  福井大学医学部感覚運動医学講座脳脊髄神経外科

書誌事項

タイトル別名

• Determining which Intractable Brain Arteriovenous Malformations should be Surgically Treated

抄録

  To evaluate the surgical risk of brain arteriovenous malformations (AVM), the Spetzler-Martin grade is effective and correlated to the occurrence of postoperative deficits. Therefore, intractable AVMs for surgical treatment were defined as the following two groups : 1) High-grade AVMs (Spetzler-Martin grade IV & V) with need to resect, 2) Low grade AVMs (grade I, II, and III) with high surgical risks evaluated by criteria or grading other than Spetzler-Martin grade.<br>  The former are mostly high-grade AVMs with hemorrhagic onset presenting with repetitive hemorrhage and progressive symptoms. On the other hand, it is not easy to evaluate the real risks of surgery for low-grade AVMs. There are a variety of risks in treating grade III AVMs.<br>  We think that using a combination of Spetzler-Martin grade and neuroimaging, especially diffusion-tensor tractography is one of the best ways to determine whether surgical treatment is advised. In our series, postoperative deterioration of motor function in AVM patients was related to the minimal distant between the nidus and corticospinal tract on tractography. We found that AVMs more than 16mm distant from the corticospinal tract could be resected safely.

収録刊行物

• Japanese Journal of Neurosurgery

  Japanese Journal of Neurosurgery 22 (1), 4-10, 2013

  日本脳神経外科コングレス

キーワード

• arteriovenous malformation
• surgical risk
• diffusion-tensor tractography

詳細情報

• CRID: 1390001204405607296
• NII論文ID: 10031131670
• NII書誌ID: AN10380506
• DOI: 10.7887/jcns.22.4
• ISSN: 21873100
• ISSN: 0917950X
• Web Site: https://search.jamas.or.jp/link/ui/2013130895
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可