最新脑动静脉畸形--大学课件(2)教学讲义ppt课件.ppt

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1、脑动静脉畸形--大学课件(2)Incidence0.52%atautopsySlightmalepreponderance(1.09to1.94)Congenitallesions(althoughrarelyfamilial)EmbryologyFirsthalfofthirdweekofgestationepiblasticcellsmigratetoformmesodermmesodermalcellsdifferentiatetoarterialandvenousvesselsonthesurfaceoftheembryonicnerv

2、oussystemPathology&PathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthPathology&Pathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsparenchymalchangeswithinandaroundt

3、helesionPathology&PathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsparenchymalchangeswithinandaroundthelesionsitefrequencyisproportionaltobrainvolumePathology&Pathophysiologyabsenceofnormalcapillary

4、systemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsClinicalpresentation95%havesymptomsbyageof70yearsClinicalpresentation95%havesymptomsbyageof70yearspeakpresentationsecondtofourthdecadeClinicalpresentation95%havesymptomsbyageof70yearspeakp

5、resentationsecondtofourthdecadehighoutputfailure,neonate,veinofGalenhydrocephalus,firstdecadeheadache,hemorrhage,seizures,2nd&3rdClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandp

6、ressuresenlargementandencroachmentClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencroachmentduralsinusesClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencroachmentduralsinusesischaemiaCl

7、inicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencroachmentduralsinusesischaemiacardiacoutputClinicalpresentationHemorrhageAVMrupturenotafunctionofsizeAneurysmrupturerelatedtoaneurysmsizeHemorrhageAVMrupturenotafunctionofsizenomarked

8、increasewithexercise,pregnancy,traumaAneurysmrupturerelatedtoaneurysmsizein