Xiang Yongjun,Wang Hangzhou,Yang Tianquan,et al.Staged surgery for supratentorial arteriovenous malformation rupture in children during acute phase[J].Journal of Clinical Pediatric Surgery,,22():881-884.[doi:10.3760/cma.j.cn101785-202207045-016]
Staged surgery for supratentorial arteriovenous malformation rupture in children during acute phase
- Keywords:
- Supratentorial arteriovenous malformation; Surgical Procedures; Operative; Microsurgical treatment; Child
- Abstract:
- Objective To explore the staged surgery for children with supratentorial arteriovenous malformation rupture and hemorrhage and evaluate the prognosis of staged treatment of arteriovenous malformation(AVM)in children.Methods From January 2015 to December 2018,retrospective analysis was conducted for clinical data of 37 children with supratentorial cerebral arteriovenous malformation hemorrhage undergoing staged surgery.Clinical manifestations,surgical approaches and follow-up outcomes were recorded.Results Emergency operation in the first stage was performed.There were intracranial hematoma evacuation(n=27)and extraventricular drainage(n=10).There was no mortality.After stabling,computed tomographic angiography(CTA)or digital subtraction angiography(DSA)was examined and the results were graded according to the Spetzler-Martin scheme.The grades were Ⅰ(n=12),Ⅱ(n=16)and Ⅲ(n=9).AVM resection was performed at Week 2 after an initial operation.DSA indicated that AVMs were completely removed at Month 6.Glasgow outcome scale(GOS)score at the end of follow-up was 5(n=32,86.5%)and 4(n=5,13.5%).No hemorrhage occurred during a follow-up period of(6-48)months.Conclusion When preoperative cerebrovascular imaging cannot be completed due to certain conditions,staged treatment of supratentorial cerebral arteriovenous malformation rupture during acute phase is a feasible option for achieving a better prognosis with less neurological dysfunction in children.
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Memo
收稿日期:2022-7-25。
基金项目:苏州市姑苏区卫生人才计划(GSWS2020051)
通讯作者:王杭州,Email:wanghangzhoudr@126.com