KHẢO SÁT TÌNH TRẠNG THIẾU VITAMIN D3 (25-OH) HUYẾT THANH Ở BỆNH NHÂN ĐAU CỘT SỐNG THẮT LƯNG MẠN TÍNH

Abstract

Objectives: To describe transcranial Doppler (TCD) ultrasound imaging and assess value diagnostic of transcranial Doppler ultrasound in patients with intracranial hemorrhage due to ruptured cerebral arteriovenous malformation (AVM). Methods: A descriptive cross-sectional study of 36 cases with ruptured cerebral AVM who were treated at Bach Mai Hospital from October 2019 to July 2021. Results: Mean age was 43±14,7 years old, male/female ratio was 1,27/1. Admisssion reasons: nausea/vomitting were 97,2%, headache was 94,4%, altered level of consciousness was 30.6% and hemiplegia was 50%. The common hemorrhagic location was in cerebral lobules. The percentage of hematoma sizes smaller than 3cm, from 3 to 6cm and greater than 6cm were 58.3%, 38.9%, and 2.8%, respectively. The ruptured AVM feeding vessels originate from midle cerebral artery were 52,78%. The AVM had 3 or 4 feeding arteries were 91,67%, had more than 4 feeding arteries were 8,33%. The AVM with pure one draining vein was 72,2%, with 2 or more draining veins was 27.8%. The confirmed diagnostic rate of AVM feb by middle cerebral artery branches by TCD ultrasound was 89,47%. Postive prediction value based on CTA for small, medium and large AVM was 40,9% 93,75% and 100%, respectively.  Mean flow velocity on the feeding vessels originate from MCA was higher than those in the contralateral MCA. (significant difference, with p <0,05). Conclusion: The predominant age group in ruptured AVM was 40 years old and above (63,9%); the mean age was 43 ± 14,7, male/female ratio was 1,27/1. The common hemorrhagic location were in cerebral lobules (85,72%), hematoma sizes smaller than 3cm with pure one draining vein was 72,2%. TCD ultrasound was the useful tool to diagnose the medium and large AVM with high sensitivity.