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題名 | Spontaneous Rupture of Cerebral Arteriovenous Malformation Presenting with Acute Flaccid Limbs Weakness and Altered Consciousness in a 12-Year-Old Female Child=一位十二歲大女童以急性肢體無力及意識改變表現之自發性大腦動靜脈畸形瘤破裂 |
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作者 | 許木嶺; 阮春榮; 陳俊榮; 薛俊仁; 陳錫洲; Hsu, Mu-ling; Juan, Chun-jung; Chen, Chun-jung; Hsueh, Chun-jen; Chen, Shyi-jou; |
期刊 | 中華民國重症醫學雜誌 |
出版日期 | 20040000 |
卷期 | 6:1 民93 |
頁次 | 頁50-55 |
分類號 | 417.62322 |
語文 | eng |
關鍵詞 | 動靜脈畸形瘤; 半癱; 意識改變; 動脈攝影術; Arteriovenous malformation; Hemiplegia; Altered consciousness; Angiography; |
中文摘要 | 我們提出一位十二歲大女童,最初臨床以非外傷性頭痛、嘔吐來表現,之後出現意識改變、進行性右半癱,臆斷為腦膜腦炎。在決定做腰椎穿刺前先安排腦部電腦斷層掃描,發現疑似自發性大腦動靜脈畸形瘤破裂,並由動脈血管攝影術證實診斷。病患緊急接受顱骨切開術並取出血塊,且置放腦室外引流管及監測腦壓。術後也接受定期復健及放射治療。此個案提醒兒科醫師,當病兒有突發擬似流感症狀合併非外傷性急性肢體無力及原因不明意識改變時,要特別提高警覺,是否有自發性大腦動脈畸形瘤破裂之可能性,以避免延誤病情。 |
英文摘要 | We present a 12-yeare-old female child with nontraumatic headache and vomiting as the initial presentation, after which altered consciousness and progressive right hemiplegia were noted. Meningoencephalitis was suspected. However, spontaneous rupture of cerebral arteriovenous malformation (AVM) was proved by the emergent brain computed tomography (CT) and angiographic examinations before performing lumbar puncture. The emergency operation of craniotomy with removal of hematoma and external ventricular drainage with intracranial pressure monitoring were preformed smoothly. After surgery, the patient received rehabilitation program and Gamma knife radiotherapy. The presence of sudden-onset flu-like symptoms or signs in association with nontraumatic acute flaccid limb weakness and altered consciousness of unknown cause should alert the pediatrician to the possibility of spontaneous rupture of cerebral arteriovenous malformation. |
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