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IR@PKUHSC  > 北京大学第一临床医学院  > 小儿外科  > 期刊论文
学科主题: 临床医学
题名:
Visual Field Preservation in Surgery of Occipital Arteriovenous Malformations: A Prospective Study
作者: 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
发表日期: 2015-11-01
DOI: 10.1016/j.wneu.2015.06.069
卷: 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
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/60541
Appears in Collections:北京大学第一临床医学院_小儿外科_期刊论文

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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

Recommended Citation:
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.
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