最新脑动静脉畸形--大学课件PPT课件.ppt

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

2、&PathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthPathology&PathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsparenchymalchangeswithinandaroundthelesionPathology&Pathophysiology

3、absenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsparenchymalchangeswithinandaroundthelesionsitefrequencyisproportionaltobrainvolumePathology&Pathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthv

4、esselschangewithtimemaydevelopaneurysmsClinicalpresentation95%havesymptomsbyageof70yearsClinicalpresentation95%havesymptomsbyageof70yearspeakpresentationsecondtofourthdecadeClinicalpresentation95%havesymptomsbyageof70yearspeakpresentationsecondtofourthdecadehighoutputfailure,neonate,veinof

5、Galenhydrocephalus,firstdecadeheadache,hemorrhage,seizures,2nd&3rdClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencroachmentClinicalpresentationfactorscontributingtosym

6、ptomsvesselwalls,flowandpressuresenlargementandencroachmentduralsinusesClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencroachmentduralsinusesischaemiaClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencr

7、oachmentduralsinusesischaemiacardiacoutputClinicalpresentationHemorrhageAVMrupturenotafunctionofsizeAneurysmrupturerelatedtoaneurysmsizeHemorrhageAVMrupturenotafunctionofsizenomarkedincreasewithexercise,pregnancy,traumaAneurysmrupturerelatedtoaneurysmsizeincre