脊髓動靜脈畸形經導管栓塞術治療：一病例報告

病人為6歲男童，因右下肢無力、疼痛持續1天而住院。到第4天時，病人兩側下肢已完全癱瘓，感覺消失，大小便失禁。脊髓腔攝影顯示在T12－L1處完全阻塞，因疑脊髓腫瘤而開刀，結果發現為混合型動靜脈畸形，而無法切除。手術後經電腦斷層攝影及血管攝影檢查，確定為胸脊髓動靜脈畸形，而決以Ivalon施行經導管栓塞術治療。術後病人下肢肌力、感覺及括約肌控制功能逐漸恢復，術後48天病人已能扶持而立，感覺及括約肌控制功能則完全復原。3年後病人除右下肢稍無力外，一切都正常。

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並列摘要

A 6-year-old boy was admitted due to right leg pain and weakness for 1 day. The condition progressed worse and worse. Areflexic paraplegia, a L2-level of total anesthesia and loss of sphinctors control were observed on the fouth ill day. A complete block between T12 and L1 was demonstrated on myelogram. Under the impression of spinal tumor, a T10 – L1 laminectomy was carried out, and a mixaed type spinal arteriovenous malformation (AVM) was found. Dural graft was done only, because it was inoperable. Spinal CT and angiography were done after operation. Spinal CT revealed abnormal attenuations of the cross-section, dotted structures of the vessels intramedullary, and relatively increased diameter of the spinal canal. Spinal angiography showed an AVM at the level of T1 to T11 with the main feeder of the intercostal artery at the T9-T10 on the left. Surgical excision of the malformation was difficult, therefore embolization with polyvinyl alcohol (Ivalon) for the lesion was performed with the femoral approach of catherization. A check angiogram showed the main feeder of the lesion was successfully occluded. His condition was improved steadily after embolization. When he was discharged, 48 days after embolization, he could stand with support and regained the sensation as well as control of sphinctors. Three years later he exhibited nearly completely normal, except slight weakness of right leg. At this time followup aortography showed a residual AVM at T11-T12.

並列關鍵字

spinal arteriovenousmalformation (spinal AVM) ； embolization

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脊髓動靜脈畸形經導管栓塞術治療：一病例報告

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