CAJ | 학술논문

目的：探讨外侧裂脑动静脉畸形的手术策略及效果。方法回顾性分析1例伴发癫痫的优势半球外侧裂动静脉畸形患者的临床资料并结合文献复习，对外侧裂动静脉畸形的解剖特点、临床解剖分型、术前功能评估、术中辅助技术的应用以及治疗策略等进行分析讨论。结果本例患者在唤醒麻醉下完整切除，术后言语及运动功能无加重，随访10个月，无癫痫发作，EngelⅠ级。结论外侧裂脑动静脉畸形术前功能评估及术中功能保护极其重要，唤醒麻醉下结合皮层电刺激可以有效保护脑功能区。神经导航辅助下，经皮层功能哑区脑沟入路优先阻断深部供血动脉，可有效控制术中出血。
목적：탐토외측렬뇌동정맥기형적수술책략급효과。방법회고성분석1례반발전간적우세반구외측렬동정맥기형환자적림상자료병결합문헌복습，대외측렬동정맥기형적해부특점、림상해부분형、술전공능평고、술중보조기술적응용이급치료책략등진행분석토론。결과본례환자재환성마취하완정절제，술후언어급운동공능무가중，수방10개월，무전간발작，EngelⅠ급。결론외측렬뇌동정맥기형술전공능평고급술중공능보호겁기중요，환성마취하결합피층전자격가이유효보호뇌공능구。신경도항보조하，경피층공능아구뇌구입로우선조단심부공혈동맥，가유효공제술중출혈。
Objective To discuss the clinical characteristics and surgical strategy of the sylvian fissure arteriovenous malformations ( AVMs) .Methods The clinical data of one patient with sylvian fissure AVMs in the dominant hemisphere were analyzed retrospectively .The anatomical features , preoperative evaluation and surgical strategy were discussed combined with literatures review . Results The AVMs and the epileptic foci were totally resected under awake anesthesia .There were no new neurological deficits postoperatively .During the ten-month follow-up period, the patient achieved seizure free after operation .Conclusion Sylvian fissure AVMs are among the most challenging AVMs to manage surgically .The functional evaluation and intraoperative protection of functional structure are extremely important in the surgical treatment of sylvian fissure AVMs .It is effective to protect important functional brain areas through brain mapping .To block the deep blood supply artery via the sulcus in the “dumb area” can effectively control the surgical bleeding .