大且深的左腦海綿狀血管畸形的處置：病例報告

The Treatment of a Large and Deeply Seated Left Cerebral Cavernous Malformation: A Case Report

黃翠莉(Chui-Lee Wong) ； 黃金山(Jin-Shan Huang)

《台灣復健醫學雜誌》 43卷1期 (2015/03) Pp. 61-69

https://doi.org/10.6315/2015.43(1)07

摘要

腦海綿狀血管畸形是先天性血管畸形，但血管攝影無法顯示它的存在。現今CT及MRI卻提升了它的診斷率，而且海綿狀血管畸形在MRI有其特徵，放射學上有助於和其他腫瘤做鑑別診斷。Zabramski等人依海綿狀血管畸形的MRI特徵和病理特徵，將海綿狀血管畸形分為四大類型，並清楚提出各類型的自然病史及出血風險，這對處置的擬定很重要。本文報告一位七十三歲女性病人，以輕微的構音不清晰及步態異常的臨床症狀表現，經由影像檢查發現位於左側額顳區深處，大小為4.5x4.5x3cm的海綿狀血管畸形。據文獻記載的海綿狀血管畸形的分類，依其自然病史、出血風險、手術的適應症及禁忌，擬定了處置方法。目前，我們採取保守的態度，繼續觀察，定期追蹤，每年做一次MRI。謹以本病例報告，文獻回顧及討論，提供臨床參考。

關鍵字

腦海綿狀血管畸形 ； 海綿狀血管畸形

並列摘要

Cerebral cavernous malformations (CCMs) are congenital vascular anomalies that are not visualized on angiography. However, computed tomography (CT) and magnetic resonance imaging (MRI) scans have highly increased the detection rate and the understanding of these lesions. CCMs have characteristic MRI findings, which facilitate differential diagnosis radiologically. CCMs are classified into 4 categories, according to their MRI and pathological characteristics. In addition, the nature history and the bleeding risk of each category of CCMs are different and critical in decision making regarding treatment. We report the case of a 73 years old female patient who presented with a history of mild dysarthria and abnormal gait for 6 months. A brain MRI image showed a cavernous malformation, 4.5x4.5x3 cm in size, deeply seated in left frontotemporal lobes. Based on the MRI characteristics, documented natural history and bleeding risk, and indications and contraindications of operations recommended in the literatures, we adopt a conservative treatment of observation and regular follow-up, checking brain MRI images annually.

並列關鍵字

Cerebral cavernous malformations ； cavernous malformations

參考文獻

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