意想不到的结果:揭示脑动脉静脉形病例中的立体性放射手术后的囊形成
Sarvesh Goyal1, Kushagra Pandey1, Shweta Kedia1
1Department of Neurosurgery, All India Institute of Medical Sciences, New-Delhi, India.
概括
对大脑动脉静脉形形进行玛刀放射手术后的囊形成是一种罕见的并发症. 及时识别和手术干预对于大多数患者的良好结果至关重要.
科学领域:
- 神经外科 神经外科
- 辐射瘤学 辐射瘤学
- 神经学 神经学
背景情况:
- 囊形成是脑动脉静脉瘤 (AVM) 的立体射线手术 (SRS) 后的罕见但显著的延迟并发症.
- 早期识别和管理对于最佳的患者结果至关重要.
研究的目的:
- 分析发生率,临床特征,管理和AVMs的玛刀放射手术 (GKRS) 后囊形成的结果.
- 审查有关这种并发症的文献,并为管理提供建议.
主要方法:
- 从2008年到2023年对玛刀治疗记录的回顾性分析.
- 鉴定和详细研究GKRS后对AVM产生囊的患者,包括临床数据,管理策略和预后.
- 综合文献综述. 这是一个全面的文献综述.
主要成果:
- 在接受治疗的921名AVM患者中,有7人出现了囊 (平均潜伏时间为6.45年).
- 患者呈现的脑内压力升高,焦点缺陷或发作;3人已经实现了 obliteration.
- 手术干预 (化,切除,解压脑膜切除) 是常见的;85.71%的患者有良好的结果,而一名患者因并发症而死亡.
结论:
- 静脉动脉瘤的GKRS后囊形成是一种未被认可的并发症,原因是发病率低,延迟时间长.
- 长期跟踪对于及时诊断至关重要.
- 建议对残留巢评估进行诊断DSA;无症状囊可以保守地管理,而症状病例需要手术干预,可能包括CSF转移.
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