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首页> 外文期刊>Neurosurgery >Occipital lobe vascular malformations: prevalence of visual field deficits and prognosis after therapeutic intervention.
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Occipital lobe vascular malformations: prevalence of visual field deficits and prognosis after therapeutic intervention.

机译：枕叶血管畸形：治疗干预后视野缺损的发生率和预后。

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BACKGROUND: The prevalence of visual field (VF) deficits in association with vascular malformations of the occipital lobe is not known, and the prognosis of the VF after therapeutic intervention has not been systematically documented. METHODS: We reviewed the clinical records of 23 consecutive patients who were managed at a single institution during a 3-year period with intracranial vascular malformations extending within the anatomic borders of the occipital lobe. Lesion location and treatment rendered were correlated with formal VF testing performed before and after therapeutic intervention. RESULTS: Twenty-one of the 23 patients underwent treatment of their lesions. Treatment included resection after preoperative embolization (12 patients), resection alone (2 patients with arteriovenous malformations and 3 patients with cavernous malformations), and stereotactic radiosurgery (4 patients; preceded by embolization in 3 of the 4). One patient was followed expectantly, and another died as a result of hemorrhage soon after undergoing endovascular embolization. The VFs were assessed before and after therapeutic intervention (follow-up assessment, 2-29 mo). New VF deficits or worsening of preexisting VF deficits were documented in 5 of the 21 treated patients (24%), but only 2 of these patients (9.5%) had persistent deficits at the time of their follow-up examinations. Among the 10 patients with pretreatment VF deficits, 5 improved and the other 5 were unchanged after treatment. CONCLUSION: Patients with occipital lobe vascular malformations frequently present with associated VF deficits. Surgical resection or stereotactic radiosurgery (with or without previous embolization) of these lesions can be performed with little risk of causing new VF deficits or worsening of preexisting ones. Many VF deficits can be expected to improve or resolve after therapy.
机译：背景：与枕叶血管畸形相关的视野缺损（VF）患病率尚不清楚，而且治疗干预后VF的预后尚未得到系统记录。方法：我们回顾了在3年期间由一家机构接受治疗的连续23例患者的临床记录，这些患者的颅内血管畸形在枕叶的解剖边界内扩展。病变部位和治疗方法与治疗干预前后进行的正式VF测试相关。结果：23例患者中有21例接受了病变治疗。治疗包括术前栓塞术后切除（12例），单独切除术（2例动静脉畸形和3例海绵状畸形）和立体定向放射外科手术（4例;在4例中有3例栓塞）。一名患者得到了预期的随访，另一名患者在接受血管内栓塞术后不久因出血而死亡。在治疗干预前后对VF进行评估（随访评估2-29个月）。在21例接受治疗的患者中，有5例（24％）记录了新的VF缺乏症或先前存在的VF缺乏症恶化，但这些患者中只有2例（9.5％）在随访检查时出现持续性缺陷。在治疗前VF缺乏的10例患者中，有5例得到改善，其他5例在治疗后未改变。结论：枕叶血管畸形患者常伴有相关的室颤缺损。可以对这些病变进行手术切除或立体定向放射外科手术（有或无先前栓塞），几乎没有引起新的VF缺陷或使先前存在的VF缺陷恶化的风险。可以预期许多VF缺陷会在治疗后改善或解决。

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