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浙江大学学报（医学版）
浙江大学学报（医学版）  2017, Vol. 46 Issue (4): 445-448    DOI: 10.3785/j.issn.1008-9292.2017.08.16
病例报告     
舌下神经管区硬脑膜动静脉瘘介入治疗二例
方兵, 钱聪, 蒋定尧, 许璟, 虞军, 陈贤谊, 徐良, 陈高, 张建民
浙江大学医学院附属第二医院神经外科, 浙江 杭州 310009
Hypoglossal canal dural arteriovenous fistulas treated with transvenous embolization:report of two cases and literature review
FANG Bing, QIAN Cong, JIANG Dingyao, XU Jing, YU Jun, CHEN Xianyi, XU Liang, CHEN Gao, ZHANG Jianmin
Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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摘要：

介绍两例舌下神经管区硬脑膜动静脉瘘患者的临床表现、影像学诊断、手术过程及疗效。两例患者临床均表现为结膜充血水肿伴耳鸣，三维深度感知飞行时间（3D-TOF）高分辨磁共振检查可见舌下神经管区异常紊乱血管影。脑血管造影检查发现该硬脑膜动静脉瘘由多支颅内外动脉供血，瘘口位于舌下神经管区域。通过静脉途径使用弹簧圈和Onyx-18胶闭塞该动静脉瘘，术后血管造影提示瘘口完全闭塞，患者症状迅速缓解且无手术并发症，术后随访无复发。
关键词： 动静脉瘘/诊断;  动静脉瘘/治疗;  栓塞;  治疗性/方法;  舌下神经/解剖学和组织学;  磁共振成像;  血管造影术;  数字减影;  病例报告    
Abstract:

Two cases of hypoglossal canal dural arteriovenous fistulas (HCDAVF) were reported. The clinical manifestation, radiological features, treatment and prognosis were reviewed. Both cases presented chemosis and pulsatile tinnitus. 3D-time-of-flight (TOF) magnetic resonance angiography (MRA) demonstrated abnormal high signal in hypoglossal canal. Cerebral digital subtraction angiography (DSA) showed that these HCDAVFs were supplied by multiple intracranial and extracranial arteries, and fistulas were located in hypoglossal canal. Fistulas were blocked by coils and Onyx-18 through transvenous approach, and the angiography after the embolism showed complete occlusion of fistula. No adverse events after treatment and no recurrence during the follow up were observed.
Key words: Arteriovenous fistula/diagnosis    Arteriovenous fistula/therapy    Embolization, therapeutic/methods    Hypoglossal nerve/anatomy &    histology    Magnetic resonance imaging    Angiography, digital subtraction    Case reports
收稿日期: 2017-03-27 出版日期: 2017-08-25
CLC:  R743  
通讯作者: 张建民(1959-),男,博士,主任医师,教授,博士生导师,主要从事脑卒中的基础和临床研究;E-mail:zjm135@vip.sina.com;http://orcid.org/0000-0003-1878-8388     E-mail: zjm135@vip.sina.com
作者简介: 方兵(1974-),男,博士,副主任医师,主要从事脑血管病的临床治疗;E-mail:fangsunny2002@126.com;http://orcid.org/0000-0003-2918-6737
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引用本文:

方兵 等. 舌下神经管区硬脑膜动静脉瘘介入治疗二例[J]. 浙江大学学报（医学版）, 2017, 46(4): 445-448.

FANG Bing, QIAN Cong, JIANG Dingyao, XU Jing, YU Jun, CHEN Xianyi, XU Liang, CHEN Gao, ZHANG Jianmin. Hypoglossal canal dural arteriovenous fistulas treated with transvenous embolization:report of two cases and literature review. Journal of ZheJiang University(Medical Science), 2017, 46(4): 445-448.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2017.08.16    或    http://www.zjujournals.com/med/CN/Y2017/V46/I4/445

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