Combined surgical interventions in the combined arteriovenous malformations and arterial cerebral aneurysmas
Keywords:
arteriovenous cerebral malformations, arterial aneurysms, microsurgical and endovascular surgeryAbstract
Detailed analysis of the combined surgical treatment results of the arteriovenous cerebral malformations (AVM) with arterial aneurysms (AA) was conducted. Depending on the features of the angioarchitecture, there were selected peripheral dependent AA, located along the course of the afferent AVM vessels, AA, located beyond the AVM supply pathways (“independent”) and AA, located in the immediate vicinity to the AVM. During 1997-2004 years 15 patients with sach combined pathology aged 14 to 43 years, were operated on. Location of 93% AVM and AA was supratentorial. 13 patients had single or multiple intracranial hemorrhages in the anamnesis and in 2 – had course epilepticus.
9 endovascular staged interventions in the AVM vessels were performed (total 24) and 6 – by microsurgical clipping, simultaneously AVM nidus extirpation had been performed as well.
The first stage of the surgery was performed by abolition of the intracerebral hematoma following by the clipping of the AA neck. In 4 cases because of increase of the aresorbtive hydrocephalus, the shunting interventions were conducted.
Obtained experience and practice of the combined surgical interventions in the combination of AVM and AA demonstrate the turth of the neighed differential approach to the treatment of vascular defects of such kind and necessity of the development of the corresponding tactical solutions.
References
Богаченко Д.В. Клинико-анатомические сопоставления при артериальных и артериовенозных аневризмах головного мозга //Диагностика и хирургическое лечение сосудистых заболеваний головного мозга. — Л., 1974. — С.193–195.
Егоров Б.Г., Кандель Э.И., Коновалов А.Н. Артериальные и артериовенозные аневризмы головного мозга //Нарушения мозгового кровообращения и их хирургическое лечение /Под.ред. Е.В.Шмидта. — М., 1967. — С.217–297.
Зозуля Ю.А. Микрохирургические операции при внутричерепных артериальных и артериовенозных аневризмах //Оперативные вмешательства при заболеваниях головного мозга. — К.: Здоровья, 1986. — С.30–33.
Мацко Д.Е., Гайкова О.Н. О сочетании внутричерепных артериовенозных пороков развития с так называемыми врожденными аневризмами //Частные вопросы онкоморфологии. — Л., 1986. — С.89–90.
Медведев Ю.А., Мацко Д.Е. Аневризмы и пороки развития сосудов головного мозга. — СПб, 1997. — Т.1. — С.70–72; Т.2. — С.51–53.
Переседов В.В. Хирургическое лечение аневризм и мальформаций головного мозга методом стереотаксического клиппирования в раннем периоде после кровоизлияния // II съезд нейрохирургов Российской Федерации: Материалы съезда. — Н.Новгород, 1998 — С.190.
Свистов Д.В., Вознесенская Н.И., Савелло А.В., Фокин В.А. Начальный опыт диагностики и комбинированного лечения сочетанных артериовенозных пороков развития //III съезд нейрохирургов России: Материалы съезда. — СПб, 2002. — С.358–359.
Филатов Ю.М., Элиава Ш.Ш., Чурилов М.В. и др. Тактика хирургического лечения сочетанных артериовенозных мальформаций и артериальных аневризм головного мозга //Журн. нейрохирургии. — 1997. — С.4–7.
Brown R.D., Wiebers D.O., Forbes G.S. Unruptured intracranial aneurysms and arteriovenous of intracranial hemorrage and relationship of lesions //J.Neurosurg. — 1990. — V.73. — P.859–863.
Marks H.P., Lane B., Steinberg C.K., Snipes G.L. Intracranial aneurysms in cerebral arteriovenous malformation: Evaluation and endovascular treatment //Radiology. — 1982. — V.183, N2. — P.305–360.
Yasargil M.G. Surgery of aneurysms and arteriovenous malformations //Abstract of 10th Europ. congr. of Neurosurgery. — Berlin, 1995. — P.24.
Downloads
How to Cite
Issue
Section
License
Copyright (c) 2004 O. A. Tsymeiko, A. I. Goncharov, M. Yu. Orlov, I. I. Skorokhoda
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.