Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (12): 60-64.doi: 10.6040/j.issn.1671-7554.0.2020.0822

Previous Articles     Next Articles

Application of ultrasound-guided electrocorticography monitoring in the microsurgical treatment of epilepsy secondary to cerebral arteriovenous malformation

SUN Yongfeng1, LIU Huizhao2, LI Yuhuan1, SHI Lei1, YUAN Jun1, ZHONG Jianwei1   

  1. 1. Department of Military Medicine and Special Disciplines;
    2. Department of Medical Imaging, Beijing Crops Hospital of Chinese Peoples Armed Police Forces, Beijing 100027, China
  • Published:2020-12-08

PDF (PC)

129

Abstract: Objective To explore the role and value of ultrasound-guided electrocorticography(ECoG)monitoring in the microsurgery of epilepsy secondary to cerebral arteriovenous malformations(cAVM). Methods The clinical data of 18 patients with epilepsy secondary to cAVM treated with microsurgery were retrospectively analyzed. During operation, the complete resection of cAVM and epileptogenic zone was under ultrasound guidance and ECoG monitoring. Results Intraoperative ultrasound could clearly show the position, boundary, feeding artery and drainage veins of cAVM; it could identify the surgical remnants so as to guide complete resection of cAVM vascular mass. ECoG could monitor the epileptic discharges and thus reduce injury on brain function. During the follow-up of more than 2 years, no neurological dysfunction or seizure occurred. The efficacy reached Engel I in all cases. Conclusion Intraoperative ultrasound guidance can accurately locate cAVM and determine its feeding artery and residual conditions, guide complete resection; ECoG monitoring determines epileptogenic zone, and further guides the scope of resection. Intraoperative ultrasound guidance combined with ECoG monitoring can effectively reduce complications and brain injury, and significantly improve the therapeutic effects.

Key words: Intraoperative ultrasound, Electrocorticography monitoring, Cerebral arteriovenous malformation, Epilepsy

CLC Number: 

  • R742.1
[1] Ollivier I, Cebula H, Todeschi J, et al. Predictive factors of epilepsy in arteriovenous malformation [J]. Neurochirurgie, 2020, 66(3): 144-149.
[2] Ditty Benjamin J, Omar Nidal B, Foreman Paul M, et al. Seizure outcomes after stereotactic radiosurgery for the treatment of cerebral arteriovenous malformations [J]. J Neurosurg, 2017, 126(3): 845-851.
[3] Takayama Mio, Hara Kenji, Matsusue Aya, et al. Giant intracranial arteriovenous malformation as the focus of epileptic seizures [J]. Neuropathology, 2018, 38(2): 185-191.
[4] 张占伟, 喻坚柏, 罗刚. 合并脑室出血的小脑幕区脑血管畸形的急诊血管内治疗(附18例报道)[J]. 中国临床神经外科杂志, 2017, 22(5): 327-329. ZHANG Zhanwei, YU Jianbo, LUO Gang. Emergency endovascular treatment of cerebellar tentorial cerebrovascular malformations complicated with intraventricular hemorrhage(report of 18 cases)[J]. Chinese Journal of Clinical Neurosurggery, 2017, 22(5): 327-329.
[5] 任伟, 汪姝. 三维DSA与MRI或CT影像融合技术要点及在颅内动静脉畸形诊治中的应用[J]. 临床研究, 2019, 27(3): 137-139. REN Wei, WANG Shu. Three-dimensional DSA and MRI or CT Image Fusion Techniques and Their Application in Diagnosis and Treatment of Intracranial Arteriovenous Malformation [J]. Clinical Research, 2019, 27(3): 137-139.
[6] 石瑞成, 赵志军, 韩建国. 脑动静脉畸形14例临床治疗体会[J]. 包头医学院学报, 2018, 34(12): 42-43. SHI Ruicheng, ZHAO Zhijun, HAN Jianguo. Treatment of 14 cases of cerebral arteriovenous malformation [J]. Journal of Baotou Medical College, 2018, 34(12): 42-43.
[7] 黄旭华, 曹杰, 何华. 介入治疗前后脑血管畸形患者MMP-2,MMP-9表达水平及意义探讨[J]. 江西医药, 2018, 53(10): 1054-1056. HUANG Xuhua, CAO Jie, HE Hua. Changes and significance of mmp-2 and mmp-9 expression in patients with cerebrovascular malformation before and after interventional therapy [J]. Jiangxi Medical Journal, 2018, 53(10): 1054-1056.
[8] Sousa EC, Teixeira MJ, Piske RL, et al. The role of preradiosurgical embolization in the management of grades Ⅲ, Ⅳ, and Ⅴ arteriovenous malformations [J]. Front Surg, 2016, 3(6): 37.
[9] Potts MB, Lau D, Abla AA, et al. Current surgical results with low- grade brain arteriovenous malformations [J]. J Neurosurg, 2015, 122(4): 912-920.
[10] 宋剑平, 朱巍. 高级别脑动静脉畸形复合手术的价值与策略[J]. 临床外科杂志, 2018, 26(7): 486-490. SONG Jianping, ZHU Wei. The value and strategy of high-grade combined surgery for cerebral arteriovenous malformations [J]. Journal of Clinical Surgery, 2018, 26(7): 486-490.
[11] 王威, 宋冬雷. 基于临床分级的颅内动静脉畸形显微外科手术治疗的风险评估[J]. 中国脑血管病杂志, 2018, 15(7): 337-339. WANG, Wei, SONG Donglei. Risk assessment of microsurgical treatment of intracranial arteriovenous malformations based on clinical grading [J]. Chinese Journal of Cerebrovascular Diseases, 2018, 15(7): 337-339.
[12] 李勇杰. 功能神经外科学[M]. 北京: 人民卫生出版社, 2018: 648.
[13] 付信飞, 卓红平, 黎俊. 分析 CT、MRI 联合在诊断颅脑动静脉畸形(AVM)的临床价值[J]. 智慧健康, 2019, 5(2): 159-160. FU Xinfei, ZHU Hongping, LI Jun. Analyzing the clinical value of combined CT and MRI in the diagnosis of craniocerebral arteriovenous malformation(AVM)[J]. Smart Healthcare, 2019, 5(2): 159-160.
[14] 张建宁. 神经外科学高级教程[M]. 北京: 人民军医出版社, 2015: 370.
[15] Huang YJ, Hsu SW, Lee TF, et al. Consistency between targets delineated by angiography, computed tomography, and magnetic resonance imaging in stereotactic radiosurgery for arteriovenous malformation [J]. Stereotact Funct Neurosurg, 2017, 95(4): 236-242.
[16] 孙立娜. 彩色多普勒超声诊断脑动静脉畸形临床价值[J]. 中国现代药物应用, 2012, 6(8): 54-55. SUN Lina. The clinical value of color Doppler ultrasonography in diagnosing cerebral arteriovenous malformation [J]. Chinese of modern Drug Application, 2012, 6(8): 54-55.
[17] 张施远, 曾春, 石海平, 等. 术中超声辅助下急诊手术切除破裂出血的大型脑动静脉畸形[J]. 中国临床神经外科杂志, 2017, 22(12): 811-814. ZHANG Shiyuan, ZENG Chun, SHI Haiping, et al. Intraoperative ultrasound-assisted emergency microsurgery for large cerebralarteriovenous malformations with hemorrhage [J]. Chinese Journal of Clinical Neurosurgery, 2017, 22(12): 811-814.
[18] 刘会昭, 王松涛, 贾维广, 等. 常规超声在颅脑占位性病变切除术中的应用[J]. 武警医学, 2012, 23(12): 1083-1085. LIU Huizhao, WANG Songtao, JIA Weiguang. The application of conventional ultrasound in the resection of brain space occupying lesions [J]. Medical Journal of the Chinese People's Armed Police Forces, 2012, 23(12): 1083-1085.
[19] Monteith Stephen, Snell John, Eames Mathew, et al. Transcranial magnetic resonance-guided focused ultrasound for temporal lobe epilepsy: a laboratory feasibility study [J]. J Neurosurg, 2016, 125(6): 1557-1564.
[20] 姜笑千, 何文, 赵继宗, 等. 颅内动静脉畸形的术中超声应用研究[J]. 中华医学超声杂志(电子版), 2006, 3(4): 213-215. JIANG Xiaoqian, HE Wen, ZHAO Jizong, et al. Application of intraoperative ultrasound in the surgical treatment of arteriovenous malformations [J]. Chinese Journal of medical ultrasound(Electronic Edition), 2006, 3(4): 213-215.
[21] 姚文华, 张德明, 朱成明, 等. 彩色多普勒超声在颅内动静脉畸形切除术中的应用[J]. 华西医学, 2011, 26(6): 896-899. YAO Wenhua, ZHANG Deming, ZHU Chengming, et al. Application of Intraoperative Ultrasonography In The Resection Of Intracranial Arteriovenous Malformation [J]. West China Medical Journal, 2011, 26(6): 896-899.
[22] 张晓峰, 零达尚, 林其炎, 等. 急诊显微手术治疗在42例颅内动静脉畸形破裂出血患者中的应用体会[J]. 贵州医药, 2018, 42(5): 63-64. ZHANG Xiaofeng, LING Dashang, LIN Qiyan, et al. The application of emergency microsurgery in 42 patients with intracranial arteriovenous malformation and hemorrhage [J]. Guizhou Medical Journal, 2018, 42(5): 63-64.
[23] Shakur Sophia F, Brunozzi Denise, Ismail Rahim, et al. Effect of Age on Cerebral Arteriovenous Malformation Draining Vein Stenosis [J]. World Neurosurg, 2018, 113(5): e654-e658.
[24] 孙永锋, 刘会昭, 钟建卫, 等. 超声引导电生理监测下手术治疗儿童海绵状血管瘤继发癫痫6例[J]. 山东大学学报(医学版), 2016, 54(4): 55-59. SUN Yongfeng, LIU Huizhao, ZHONG Jianwei, et al. Ultrasound guidance and electrophysiological monitoring in microsurgical treatment of 6 cases of cavernous hemangioma in children with secondary epilepsy [J]. Journal of Shandong University(Health Sciences), 2016, 54(4): 55-59.
[25] Trujillo LT, Stanfield CT, Vela RD. The effect of electroencephalogram(EEG)reference choice on information-theoretic measures of the complexity and integration of EEG signals [J]. Front Neurosci, 2017, 11(7): 425.
[1] GE Li-Juan, JIN Rui-Feng, WANG Ji-Wen, HU Xin-Sheng, LIKun. Association between the C1236T polymorphism in multi-drug resistance gene 1 and response to antiepileptic drug treatment in epileptic patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2209, 47(6): 99-102.
[2] LI Yan, GUO Jun, WANG Rongqi, LIU Yongling. Sturge-Weber syndrome in patients with intractable epilepsy: a clinicopathologic study of 7 cases [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(4): 91-95.
[3] SUN Yongfeng, LIU Huizhao, ZHONG Jianwei, WANG Tao, YUAN Jun, ZHAI Weidong. Ultrasound guidance and electrophysiological monitoring in microsurgical treatment of 6 cases of cavernous hemangioma in children with secondary epilepsy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 55-59.
[4] JIA Junwei, ZHOU Xueying, LI Qiuhong, YU Kai, ZHOU Guoyu, ZHOU Shengnian. Expression of Annexin A7 in brain tissue of pilocarpine-induced epilepsy mouse model [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 6-10.
[5] ZHAO Zhenying, ZHOU Xueying, LIU Liqing, LIU Feng, ZHOU Shengnian. Altered expression of dipeptidyl peptidase 6 in patients with intractable temporal lobe epilepsy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(10): 37-41.
[6] DING Juan, JIANG Hong, PAN Fang. Association of the marital quality and psychological stress in patients with epilepsy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(8): 99-102.
[7] LI Jing， LI Bao-min， LEI Ge-fei， JIA Gui-juan， TONG Li-li， WANG Ji-wen. Atypical presentations of benign childhood epilepsy with centrotemporal spikes [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(7): 42-44.
[8] ZHANG Huan-li1, CUI Ya-zhou2, ZHOU Xiao-yan2, SHANG Wei1. Comparative proteomic study of epileptic foci in  patients with epilepsy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(3): 80-84.
[9] LIU Jing, LI Bao-min, SUN Ruo-peng, ZHANG Dong-qing, LI Jun. Dynamic changes of mossy fiber sprouting caused by seizures in immature rats and its relationship with spontaneous recurrent seizures [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(11): 16-20.
[10] ZHANG Yan-xiang1,2, CHI Zhao-fu1, LIU Xue-wu1, YANG Xue1, CHENG Rui1. Intrahippocampal infusion of lipopolysaccharide induces
seizures and the associated mechanism [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(9): 1-5.
[11] WEI Sheng-cheng1, WANG Zhi-gang1, QU Chun-cheng1, TENG Liang-zhu2. Imaging characteristics and surgical treatment of Sturge-Weber syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(5): 95-.
[12] ZHOU Hai-yan, LI Bao-min, YIN Ping, SUN Ruo-peng. Effect of triptolide on protection of neurons in the hippocampus of
 epileptic rats induced by lithium chloridepilocarpine [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(5): 20-.
[13] WANG Bin1, CHI Hua-Ji2, YUAN Fang-Shu3. Effects of an anti-epileptic compound on learning and  memory ability of epileptic mice [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(7): 53-56.
[14] SUN Xi-bo, HAN Yu-xiang, HAN Tao, WANG Xue, ZHAO Xiu-he, LIU Xue-wu, CHI Zhao-fu. Effects of diazoxide on neuronal ultrastructure and free radicals in the  hippocampus of epileptic rats induced by lithium-pilocarpine [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(2): 19-23.
[15] RONG Jia1, CUI Ya-zhou2, ZHOU Xiao-yan2, SHANG Wei1. Proteomic study of differentially expressed proteins in the hippocampus of the rat model with  temporal lobe epilepsy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(2): 39-.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd