摘要
目的探讨大脑中动脉囊性动脉瘤(MCAA)的临床特点和显微手术治疗策略。方法回顾性分析2005年1~12月手术治疗37例MCAA患者的病历资料。结果37例患者共发现MCAA38个,位于大脑中动脉近端(M1As)11个、大脑中动脉分叉部(MbifAs)25个、大脑中动脉远端(MdistAs)2个;MCAA发生破裂者32例,脑内血肿发生率37·5%;入院时Hunt-Hess0级3例、Ⅰ级3例、Ⅱ级9例、Ⅲ级15例、Ⅳ级5例、Ⅴ级2例;所有患者均在电生理检测下,经翼点或改良翼点入路,显微镜下顺行或逆性循大脑中动脉打开侧裂,分离并夹闭动脉瘤颈;术中微血管多普勒检测夹闭前后MCAA及其重要分支的血流状况,确保瘤夹放置满意;38个动脉瘤均以一枚或多枚动脉瘤夹夹闭;术后恢复良好25例;22例获随访6月,GOS4~5分16例、GOS2~3分5例、GOS1分1例、死亡1例。结论联合多种影像学检查手段,术前充分做好手术计划,并在电生理检测和微血管多普勒的辅助下,显微手术治疗大脑中动脉动脉瘤可获得满意疗效。
ObjectiveTo investigate the clinical features and microsurgical management of the middle cerebral artery aneurysms (MCAAs). MethodsThe data of 37 cases of MCAAs were analyzed retrospectively, who were managed microsurgically from January to December 2005. 38 MCAAs were detected in 37 patients including 11 M1As, 25 MbifAs and 2 MdistAs. 32 MCAAs ruptured before the operation, of which 37.5% incurred the intracerebral hematoma. Based on Hunt-Hess Grade, 3 cases were grade 0, 3 cases grade Ⅰ, 9 cases grade Ⅱ, ...
出处
《实用医院临床杂志》
2008年第2期38-40,共3页
Practical Journal of Clinical Medicine
关键词
大脑中动脉囊性动脉瘤
显微手术治疗
电生理检测
微血管多普勒
Saccular middle cerebral artery aneurysm
Microsurgical management
Electrophysiological monitoring
Microvascular Doppler
