医学优质课件精选脑动静脉畸形.ppt
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1、 脑动静脉畸形执教教师:XXXCEREBRALARTERIOVENOUS MALFORMATIONSAVM: a TLA for the CNSIncidencen0.52%at autopsynSlight male preponderance (1.09 to 1.94)nCongenital lesions (although rarely familial)EmbryologynFirst half of third week of gestationepiblastic cells migrate to form mesodermmesodermal cells differenti
2、ate to arterial and venous vessels on the surface of the embryonic nervous systemEmbryologynFirst half of third week of gestationepiblastic cells migrate to form mesodermmesodermal cells differentaite to arterial and venous vessels on the surface of the embryonic nervous systemnSeventh gestational w
3、eekvessels sprout branches & penetrate developing brainreach the gray-white interface, either loop back to pial surface or traverse entire neural tube, thus epicerebral & transcerebral circneventually connect arterial and venous systems by around the twelfth week Pathology & Pathophysiologynabsence
4、of normal capillary systemPathology & Pathophysiologynabsence of normal capillary systemnusual function displacedPathology & Pathophysiologynabsence of normal capillary systemnusual function displacednasymptomatic at birthPathology & Pathophysiologynabsence of normal capillary systemnusual function
5、displacednasymptomatic at birthnvessels change with timenmay develop aneurysmsnparenchymal changes within and around the lesionPathology & Pathophysiologynabsence of normal capillary systemnusual function displacednasymptomatic at birthnvessels change with timenmay develop aneurysmsnparenchymal chan
6、ges within and around the lesionnsite frequency is proportional to brain volumePathology & Pathophysiologynabsence of normal capillary systemnusual function displacednasymptomatic at birthnvessels change with timenmay develop aneurysmsClinical presentationn95%have symptoms by age of 70 yearsClinical
7、 presentationn95%have symptoms by age of 70 yearsnpeak presentation second to fourth decadeClinical presentationn95%have symptoms by age of 70 yearsnpeak presentation second to fourth decadehigh output failure, neonate, vein of Galenhydrocephalus, first decadeheadache, hemorrhage, seizures, 2nd & 3r
8、dClinical presentationnfactors contributing to symptomsvessel walls, flow and pressuresClinical presentationnfactors contributing to symptomsvessel walls, flow and pressuresenlargement and encroachmentClinical presentationnfactors contributing to symptomsvessel walls, flow and pressuresenlargement a
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