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学科主题临床医学
Visual Field Preservation in Surgery of Occipital Arteriovenous Malformations: A Prospective Study
Tong, Xianzeng1,2,3,4; Wu, Jun1,2,3,4; Lin, Fuxin1,2,3,4; Cao, Yong1,2,3,4; Zhao, Yuanli1,2,3,4; Jin, Zhen5; Ning, Bo1,2,3,4; Zhao, Bing1,2,3,4; Li, Yu6; Wang, Lijun1,2,3,4; Zhang, Shuo1,2,3,4; Wang, Shuo1,2,3,4; Zhao, Jizong1,2,3,4
关键词Arteriovenous malformation Diffusion tensor imaging Functional MRI Microsurgery Neuronavigation Visual field deficits
刊名WORLD NEUROSURGERY
2015-11-01
DOI10.1016/j.wneu.2015.06.069
84期:5页:1423-1436
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Clinical Neurology ; Surgery
研究领域[WOS]Neurosciences & Neurology ; Surgery
关键词[WOS]VASCULAR MALFORMATIONS ; HOMONYMOUS HEMIANOPIA ; BRAIN ; NEURONAVIGATION ; RADIOSURGERY ; STIMULATION ; HEMIFIELD ; MIGRAINE ; PATHWAY
英文摘要

OBJECTIVE: We reviewed our prospective study of patients with occipital arteriovenous malformations (AVMs) to assess whether the display of optic radiation diffusion tensor imaging (DTI) during neuronavigation-guided surgery can reduce the severity of postoperative visual field deficits (VFDs) and to evaluate the factors associated with visual field preservation.

METHODS: Forty-six consecutive patients with occipital AVMs were randomized in our study. DTI of the optic radiation was displayed during neuronavigation surgery in 24 patients. The other 22 patients were treated surgically without neuronavigation. Modified Rankin Scale (mRS) scores and visual fields were evaluated preoperatively, immediately after surgery, and at the last follow-up.

RESULTS: The patients′ baseline characteristics and AVM features were statistically similar between the 2 surgical groups. The postoperative obliteration rate was 100%. The postoperative mRS scores did not differ between the 2 groups (P > 0.05). Preexisting VFDs were more common (P =0.00004) in patients who bled than in those with unruptured AVMs. The application of DTI-incorporated neuronavigation reduced the frequency and severity of postoperative VFDs (P =0.013 and 0.001, respectively). Visual fields were more likely to be preserved in patients with an AVM > 5 mm from the optic radiation (P =0.025).

CONCLUSIONS: A history of hemorrhage is an independent risk factor for VFDs associated with occipital AVMs. Although not showing superiority in postoperative mRS, functional MRI navigation-guided surgery may help to radically resect occipital AVMs and preserve patient visual fields. A 5-mm distance from the optic radiation may be a suitable safety margin for visual field preservation.

语种英语
WOS记录号WOS:000364533900040
引用统计
被引频次:4[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/60541
专题北京大学第一临床医学院_小儿外科
作者单位1.China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China
2.Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China
3.Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China
4.PLA, Hosp 306, Med Imaging Ctr, Beijing, Peoples R China
5.Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China
6.Peking Univ, Hosp 1, Dept Pediat Surg, Beijing 100871, Peoples R China
推荐引用方式
GB/T 7714
Tong, Xianzeng,Wu, Jun,Lin, Fuxin,et al. Visual Field Preservation in Surgery of Occipital Arteriovenous Malformations: A Prospective Study[J]. WORLD NEUROSURGERY,2015,84(5):1423-1436.
APA Tong, Xianzeng.,Wu, Jun.,Lin, Fuxin.,Cao, Yong.,Zhao, Yuanli.,...&Zhao, Jizong.(2015).Visual Field Preservation in Surgery of Occipital Arteriovenous Malformations: A Prospective Study.WORLD NEUROSURGERY,84(5),1423-1436.
MLA Tong, Xianzeng,et al."Visual Field Preservation in Surgery of Occipital Arteriovenous Malformations: A Prospective Study".WORLD NEUROSURGERY 84.5(2015):1423-1436.
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