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脑动静脉畸形

最后审阅: 1 Nov 2024
最后更新: 17 Mar 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 突发性局部神经功能缺损
  • 惊厥
  • 意识水平降低
完整详情

其他诊断因素

  • 突发头痛
  • 恶心
  • 呕吐
  • 意识模糊
  • 渐进性头痛
  • 高血压
  • 昏迷
  • 渐进性局灶性神经功能缺损
  • 认知功能障碍
完整详情

危险因素

  • 家族性(畸形)
  • 出血史(出血危险因素)
  • 药物滥用(出血危险因素)
  • 异常静脉引流(出血的危险因素)
  • 小的AVMs(出血的危险因子)
  • 后颅窝及深的AVMs(出血危险因素)
  • 并发的动脉瘤(出血的危险因素)
  • 妊娠(出血的危险因素)
  • 高血压(出血的危险因素)
完整详情

诊断性检查

首要检查

  • 头颅 CT
  • 脑部 MRI
完整详情

需考虑的检查

  • 脑数字减影血管造影
  • 脑CT血管造影
  • 脑血管磁共振
  • 全血细胞计数 (FBC)
  • 凝血筛查及分组
  • 电解质检查
  • 药物毒理筛查
  • 功能成像
  • 超选择性Wada试验
  • 神经心理学
  • 脑灌注检查
  • 脑电图检查
  • 视野检查
完整详情

新兴检查

  • 4D CT 血管造影术 (CTA)/磁共振血管成像 (MRA)

治疗流程

初步治疗

合并明显占位效应的血肿

急症处理

不宜手术的患者

具备手术治疗条件的患者

妊娠

撰稿人

作者

Mervyn Lim, MBBS, MRCS, MPH

Senior Resident

Department of Neurosurgery

National University Health System

Singapore

利益声明

ML declares that he has no competing interests.

Leonard Yeo, MBBS, MRCP, MMed, ASN

Senior Consultant

Department of Medicine (Neurology)

National University Health System

Assistant Professor

Yong Loo Lin School of Medicine

National University of SIngapore

Singapore

利益声明

LY declares that he has no competing interests.

Benjamin Tan, MBBS, MRCP, MMed

Associate Consultant

Department of Medicine (Neurology)

National University Health System

Singapore

利益声明

BT declares that he has no competing interests.

Adriel Leong, MBBS, MRCS

Senior Resident

Department of Neurosurgery

National University Health System

Singapore

利益声明

AL declares that he has no competing interests.

Audrey Tan, BSc Medical Sciences (Hons), MBChB, MRCS

Senior Resident

Department of Neurosurgery

National University Health System

Singapore

利益声明

AT declares that he has no competing interests.

Pervinder Bhogal, MBBS

Consultant

Department of Radiology

St Bartholomew's and The Royal London Hospital

London

UK

利益声明

PB declares that he has no competing interests.

Yang Cunli, MBBS, FRCR, MMed, FAMS

Senior Consultant

Department of Diagnostic Imaging

National University Health System

Assistant Professor

Yong Loo Lin School of Medicine

National University of Singapore

Singapore

利益声明

YC declares that he has no competing interests.

Anil Gopinathan, MBBS, MD, DNB, FRCR, FAMS

Head of Division of Interventional Radiology

Senior Consultant

Department of Diagnostic Imaging

National University Health System

Assistant Professor

Yong Loo Lin School of Medicine

National University of Singapore

Singapore

利益声明

AG declares that he has no competing interests.

鸣谢

Dr Leonard Yeo, Dr Benjamin Tan, Dr Adriel Leong, Dr Audrey Tan, Dr Mervyn Lim, Dr Pervinder Bhogal, Dr Yang Cunli, and Dr Anil Gopinathan would like to gratefully acknowledge Dr Charles Matouk, Dr Catherine E. Gilkes, and Dr Richard J. Edwards, previous contributors to this topic, and the additional contribution of Dr Branden Cord and Dr Ryan Hebert.

利益声明

CM, CEG, and RJE declare that they have no competing interests.

同行评议者

Bernhard Meyer, MD

Chairman

Professor of Neurosurgery

Department of Neurosurgery

Technical University of Munich

Munich

Germany

利益声明

BM declares that he has no competing interests.

Michael Chen, MD

Assistant Professor of Neurology

Neurosurgery and Radiology

Rush University Medical Center

Chicago

IL

利益声明

MC declares that he has no competing interests.

Jae H. Choi, MD

Research Director

Stroke Center/The Neurological Institute

Columbia-Presbyterian Medical Center

New York

NY

利益声明

JHC declares that he has no competing interests.

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