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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Balloon-Occlusion Catheter Onyx Embolization of a Spinal Dural Arteriovenous Fistula Presenting with Subarachnoid Hemorrhage in a Pediatric Patient
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Balloon-Occlusion Catheter Onyx Embolization of a Spinal Dural Arteriovenous Fistula Presenting with Subarachnoid Hemorrhage in a Pediatric Patient

机译：儿科患者蛛网膜下腔出血的硬脊膜动静脉瘘的球囊闭塞On玛瑙栓塞术

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Objective: Spinal dural arteriovenous fistulas (DAVFs) are insidious pathologies that, if left untreated, harbor potentially devastating consequences to the central nervous system. Spinal DAVFs are rare in the adult population and exceedingly uncommon in the pediatric population. In this report, we describe a spinal DAVF in a 3-year-old child whose initial presentation is subarachnoid hemorrhage (SAH). Balloon-test occlusion and balloon-catheter-assisted embolization of DAVF have not been previously described, and their advantages over alternative embolic and surgical techniques are discussed. Methods: We performed a literature search on MEDLINE/PubMed to review current reports describing the epidemiology, clinical presentation, and treatment of spinal DAVFs. In this report, we describe a spinal DAVF in a 3-year-old child whose initial presentation is SAH. Results: A spinal DAVF was diagnosed after deciding to image not only the brain but also the spine. Using a balloon-occlusion catheter, we confirmed that the DAVF arterial feeding vessel could be safely embolized. We then proceeded to effectively treat the DAVF with balloon-catheter-assisted Onyx-18 embolization. Conclusion: Based on our report and an analysis of the literature, we propose that pediatric patients presenting with nontraumatic SAH should undergo at least a magnetic resonance imaging of the brain and cervical spine as part of their initial workup. In addition, we describe a balloon-occlusion catheter embolization technique that allows not only excellent embolic penetration of the fistula but also prevention of microcatheter reflux and lessening of the need for a tedious plug-and-stack technique.
机译：目的：脊髓硬脑膜动静脉瘘（DAVF）是一种隐匿性病理，如果不及时治疗，将对中枢神经系统造成潜在的破坏性后果。脊椎DAVFs在成人人群中很少见，在儿科人群中极为罕见。在本报告中，我们描述了一个3岁儿童的脊髓DAVF，其最初表现为蛛网膜下腔出血（SAH）。先前没有描述DAVF的球囊测试闭塞和球囊导管辅助栓塞，并且讨论了它们比其他栓塞和手术技术的优势。方法：我们在MEDLINE / PubMed上进行了文献检索，以回顾当前描述脊髓DAVF的流行病学，临床表现和治疗的报告。在本报告中，我们描述了一个最初表现为SAH的3岁儿童的脊髓DAVF。结果：决定不仅对大脑而且对脊柱成像后，诊断出脊髓DAVF。使用气囊阻塞导管，我们确认DAVF动脉供血血管可以安全栓塞。然后，我们开始用球囊导管辅助Onyx-18栓塞术有效治疗DAVF。结论：根据我们的报告和文献分析，我们建议患有非创伤性SAH的小儿患者应至少对脑和颈椎进行磁共振成像，作为其最初检查的一部分。此外，我们描述了一种球囊闭塞导管栓塞技术，它不仅可以使瘘管极好的栓塞穿透，还可以防止微导管回流，并减少了繁琐的即插即用技术。

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