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目的:分析儿童出血型幕上深部脑动静脉畸形(BAVM)的临床特点、治疗方法及疗效。方法:回顾性分析2020年5月至2023年1月南京医科大学附属儿童manbet官网登录 神经外科治疗的12例出血型幕上深部BAVM患儿的临床资料，其中男7例，女5例，年龄4.8～14.1(9.6±3.2)岁。依据颅内出血位置、神经功能障碍程度及畸形团血管构筑情况，急诊给予侧脑室外引流术、复合手术、颅内血肿清除术或脱水降颅压治疗，生命体征平稳后给予动静脉畸形栓塞治疗。回顾性分析患儿的临床症状、影像学特点、治疗风险及疗效。结果:12例患儿均以脑出血起病，脑血管造影诊断深部BAVM，畸形团位于胼胝体压部6例，胼胝体体部3例，基底核区2例，丘脑1例。10例患儿出血以脑室内积血为主，6例患儿急诊行侧脑室外引流术，发病后7～14 d行动静脉畸形栓塞术，2例患儿发生围术期相关并发症，1例患儿发生术中出血，但术后无神经功能障碍，1例患儿术后出现短暂面部麻木；1例患儿为枕叶出血合并侧脑室内积血，急诊行复合手术栓塞畸形团及清除颅内血肿；1例患儿为基底核区出血合并侧脑室内积血，急诊行颅内血肿清除术，并于术后7 d行动静脉畸形栓塞术。复合手术和栓塞治疗术后3个月、伽马刀治疗术后3年复查脑血管造影，单次介入栓塞治愈5例(含复合手术1例)，单次栓塞并行伽马刀治疗治愈1例。结论:儿童深部BAVM颅内出血以脑室内积血为主，急性期以处理梗阻性脑积水、脑实质内血肿导致的颅高压为主，介入栓塞治疗幕上深部BAVM是安全有效的。

Objective:To analyze the clinical characteristics, treatment methods, and efficacy of hemorrhagic supratentorial deep brain arteriovenous malformation(BAVM) in children.Methods:Clinical data of 12 pediatric patients with hemorrhagic supratentorial deep BAVM diagnosed and treated in the Department of Neurosurgery, Children′s Hospital of Nanjing Medical University from May 2020 to January 2023 were retrospectively analyzed.Among them, there were 7 males and 5 females, aged range from 4.8 to 14.1(9.6±3.2) years old.On the day of onset, the children underwent lateral external ventricular drainage, combined surgery, evacuation of intracranial hematoma, or medication to reduce intracranial pressure, based on the location of intracranial hemorrhage, degree of neurological dysfunction, and angioarchitecture of BAVM.Afterwards, the patients were given embolization with stable physical signs.The data of 12 patients were analyzed retrospectively, including clinical manifestations, imaging features, and treatment outcomes.Results:All 12 children started with intracranial hemorrhage.Digital subtraction angiography confirmed the diagnosis of deep BAVM, with 6 cases having the niduses in the splenium of the corpus callosum, 3 cases in the body of the corpus callosum, 2 cases in the basal ganglia area, and 1 case in the thalamus.Ten children had an intracranial hemorrhage in the lateral ventricle.Among them, 6 children underwent lateral external ventricular drainage on the day of onset and then were given BAVM embolization 7-14 days after onset; 1 patient experienced intraoperative bleeding, but showed no neurological dysfunction after surgery; 1 patient experienced temporary facial numbness; 1 patient with massive hemorrhages in the occipital lobe and lateral ventricle underwent combined surgery to embolize the BAVM and remove intracranial hematoma on the first day of onset; 1 patient suffered from basal ganglia hemorrhage with lateral intraventricular hemorrhage, and evacuation of intracranial hematoma was performed on the day of onset, and BAVM embolization was performed 7 days after surgery.Three months after combined surgery and embolization and 3 years after gamma knife treatment, the digital subtraction angiography was re-performed, and results showed that 5 cases, including 1 child undergoing combined surgery, was cured through a single interventional embolization, and 1 case was cured by a single embolization combined with gamma knife treatment.Conclusions:Intracranial hemorrhage caused by deep BAVM in children is mainly located in the lateral ventricle.In the acute phase, the main focus is on treating intracranial hypertension caused by obstructive hydrocephalus and intracranial parenchymal hematoma.Interventional embolization is safe and effective in the treatment of deep BAVM in children.