PDF(Pubmed)
Abstract：
In the surgical treatment of cerebral vascular malformations, e.g., aneurysms and arteriovenous malformations, the risk of ischemic complications is 6.7%, and a residual aneurysm is possible in 5.2% of these cases. Ischemic lesions can result in permanent neurological deficits, and a residual aneurysm can lead to the recurrence of the aneurysm in 2% of cases. In this article, we present five cases (two cases of ruptured aneurysms, two cases of non-ruptured aneurysms, and a case of arteriovenous malformation) in which we reduced the aforementioned risks with the use of intraoperative neuromonitoring and angiography. Intraoperative neuromonitoring (IONM) is used to measure motor and sensory-evoked potentials to detect brain hypoperfusion. Intraoperative angiography with the dye indocyanine green (ICG-A), which fluoresces in a vessel under a microscope after intravenous administration, helps to identify residual aneurysm sacs and distal blood flow. With the use of IONM and ICG-A, we identified abnormalities and adjusted our interventions and treatments. IONM and ICG-A can lead to a better outcome after surgical treatment of cerebral vascular abnormalities.
摘要：
在脑血管畸形的外科治疗中，例如，动脉瘤和动静脉畸形,缺血性并发症的风险为6.7%，在这些病例中，有5.2%的患者可能存在残余动脉瘤。缺血性损伤会导致永久性的神经功能缺损,残留的动脉瘤可导致2%的动脉瘤复发。在这篇文章中,我们介绍了5例（2例动脉瘤破裂，两例未破裂动脉瘤,和一例动静脉畸形），其中我们通过使用术中神经监测和血管造影降低了上述风险。术中神经监测（IONM）用于测量运动和感觉诱发电位，以检测大脑灌注不足。染料吲哚菁绿（ICG-A）的术中血管造影，静脉注射后在显微镜下的血管中发出荧光，有助于识别残余的动脉瘤囊和远端血流。随着IONM和ICG-A的使用，我们发现了异常,并调整了干预措施和治疗.IONM和ICG-A可以在脑血管异常的手术治疗后导致更好的结果。
