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ID:39680789
大小:227.60 KB
页数:42页
时间:2019-07-09
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1、CEREBRALARTERIOVENOUSMALFORMATIONSAVM:aTLAfortheCNSIncidence0.52%atautopsySlightmalepreponderance(1.09to1.94)Congenitallesions(althoughrarelyfamilial)EmbryologyFirsthalfofthirdweekofgestationepiblasticcellsmigratetoformmesodermmesodermalcellsdifferentiatetoarterialandvenousvesselsonthesurfaceofthee
2、mbryonicnervoussystemEmbryologyFirsthalfofthirdweekofgestationepiblasticcellsmigratetoformmesodermmesodermalcellsdifferentaitetoarterialandvenousvesselsonthesurfaceoftheembryonicnervoussystemSeventhgestationalweekvesselssproutbranches&penetratedevelopingbrainreachthegray-whiteinterface,eitherloopba
3、cktopialsurfaceortraverseentireneuraltube,thusepicerebral&transcerebralcirc'neventuallyconnectarterialandvenoussystemsbyaroundthetwelfthweekPathology&PathophysiologyabsenceofnormalcapillarysystemPathology&PathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedPathology&Pathophysiologyab
4、senceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthPathology&PathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsparenchymalchangeswithinandaroundthelesionPathology&Pathophysiologyabsenceofnormalcapillarysys
5、temusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneurysmsparenchymalchangeswithinandaroundthelesionsitefrequencyisproportionaltobrainvolumePathology&Pathophysiologyabsenceofnormalcapillarysystemusualfunctiondisplacedasymptomaticatbirthvesselschangewithtimemaydevelopaneury
6、smsClinicalpresentation95%havesymptomsbyageof70yearsClinicalpresentation95%havesymptomsbyageof70yearspeakpresentationsecondtofourthdecadeClinicalpresentation95%havesymptomsbyageof70yearspeakpresentationsecondtofourthdecadehighoutputfailure,neonate,veinofGalenhydrocephalus,firstdecadeheadache,hemorr
7、hage,seizures,2nd&3rdClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresClinicalpresentationfactorscontributingtosymptomsvesselwalls,flowandpressuresenlargementandencroachmentClini
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