...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Neurosurgery >Emergency craniotomy for intraparenchymal massive hematoma after embolization of supratentorial arteriovenous malformations.
【24h】

Emergency craniotomy for intraparenchymal massive hematoma after embolization of supratentorial arteriovenous malformations.

机译：幕上动静脉畸形栓塞后急诊开颅治疗实质内大血肿。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: We sought to evaluate the efficacy of emergency craniotomy for patients with massive hematoma secondary to endovascular embolization of supratentorial arteriovenous malformations (AVMs) and to investigate relevant factors affecting outcome. METHODS: Within the past 15 years, 605 patients with intracranial AVMs have undergone 1066 endovascular embolizations at our institution. Of these, 24 patients experienced intracranial hemorrhage during or after the procedure. Fourteen patients were demonstrated to have massive intraparenchymal hematomas and deteriorated to a comatose state (Glasgow Come Scale score < or =6). Twelve patients underwent craniotomy within 170 minutes of being diagnosed with intraparenchymal hemorrhage. The surgical procedures performed were hematoma evacuation with total (6 patients) or partial (2 patients) resection of the AVM or hematoma evacuation only (4 patients). The clinical records of these 12 patients were analyzed retrospectively. RESULTS: Nine patients recovered to a favorable condition (good recovery, four patients; moderately disabled, five patients), one patient remained in a persistent vegetative state, and two patients died. The interval between hemorrhage and emergency craniotomy was significantly shorter in patients with favorable outcomes than in those with poor clinical outcomes. Advanced age and a larger volume of intraoperative blood loss were the factors relevant to poor outcome. Temporal lobe location of the AVM and incomplete embolization tended to correlate to poor clinical outcome, but this correlation was not statistically significant. The sizes of the AVM and the hematoma did not correlate to patient outcome. There was no difference in outcomes with regard to the surgical procedure performed. CONCLUSION: In patients with massive postembolization hematomas, emergency craniotomy should be performed as soon as possible to achieve a favorable outcome. Cooperation among interventional neuroradiologists, intensive care physicians, and neurosurgeons is essential to manage AVM patients with critical postembolization hemorrhage. There is no need to persist in performing simultaneous total resection of the AVM at the emergency craniotomy.
机译：目的：我们试图评估紧急开颅手术对继发于幕上动静脉畸形（AVM）的血管内栓塞继发的大面积血肿患者的疗效，并调查影响预后的相关因素。方法：在过去的15年中，我们机构对605例颅内AVM患者进行了1066例血管内栓塞。其中，有24名患者在手术过程中或手术后发生颅内出血。证实有14名患者患有实质性实质内血肿，并恶化为昏迷状态（格拉斯哥Come Scale评分<或= 6）。 12名患者在被诊断为实质性内出血后170分钟内接受了开颅手术。所执行的手术程序为完全切除AVM的血肿切除术（6例）或部分切除术（2例患者）或仅切除血肿的4例。回顾性分析这12例患者的临床记录。结果：9例患者恢复到良好状态（良好恢复，4例;中度残疾，5例），其中1例仍处于持续的植物状态，2例死亡。结果良好的患者的出血与紧急开颅手术之间的间隔明显短于临床结果较差的患者。高龄和术中大量失血与不良预后相关。 AVM的颞叶位置和不完全栓塞往往与不良的临床预后相关，但这种相关性在统计学上不显着。 AVM和血肿的大小与患者预后无关。所进行的手术程序在预后方面没有差异。结论：对于栓塞后血肿较大的患者，应尽快进行紧急开颅手术，以取得良好的效果。介入神经放射科医生，重症监护医师和神经外科医生之间的合作对于治疗伴有严重栓塞后出血的AVM患者至关重要。无需在紧急开颅手术中同时进行AVM的全切术。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号