临床神经外科杂志2011，Vol.8Issue(3)：153-156,4.DOI:10.3969/j.issn.1672-7770.2011.03.013
显微手术治疗大脑中动脉分叉部动脉瘤
Microsurgical treatment for middle cerebral artery bifurcation aneurysms
王洪生 1杨昭伟 1徐新文 1王辉 1赵佩林 1王阳春1
作者信息
- 1. 075000,张家口,解放军第二五一医院神经外科
- 折叠
摘要
Abstract
Objective To explore the regional surgical anatomy, clinical characteristics,neuroradiological manifestation, microsurgical skill and clinical effectiveness of middle cerebral artery ( MCA) bifurcation aneurysms. Methods The clinical data of 41 patients with MCA bifurcation aneurysms treated by microsurgical operation in our hospital were analyzed restrospectively , of whom 39 patients presented with clinical manifestations of aneurysmal rupture.According to Hunt-Hess classification, 5 belonged in grade 0 ～ Ⅰ , 15 in grade Ⅱ , 11 in grade Ⅲ ,9 in grade Ⅳ and 1 in grade Ⅴ. All patients were made a definite diagnosis by 64 rows helical CT angiography ( CTA). 41 patients were performed micorsurgical management through operation of transpterional approach or extended transpterional approach. The multiple intracranial aneurysms were treated through the method of combining early-stage with select-stage operation and one-stage with two-stage operation, the operating principle was the ruptured aneurysm been treated firstly and the unruptured aneurysm been treated secondly. Results Clipping was carrying out in 36 cases, clipping plus wrapping in 4, clipping in one side aneurysm and another side one did not treat in 1.Surgical outcome were good in 31 cases, light disability in 6, severe disability in 2 and 2 in dead.Conclusion The surgical outcome are predominance that MCA bifurcation aneurysms are performed microsurgical operation. The regional surgical anatomy of MCA bifurcation aneurysms should be clearly borne in mind in order to avoid the damage to the arteries and postoperative neurological deficits. Emergency hematoma evacuation and aneurysms clipping should be performed in the patients with intracerebral hematoma due to aneurysm rupture.关键词
大脑中动脉/动脉瘤/显微手术/预后Key words
middle cerebral artery/ aneurysm/ microsurgical treatment/ outcome分类
医药卫生引用本文复制引用
王洪生,杨昭伟,徐新文,王辉,赵佩林,王阳春..显微手术治疗大脑中动脉分叉部动脉瘤[J].临床神经外科杂志,2011,8(3):153-156,4.
