前交通动脉瘤的诊断和治疗

Diagnosis and treatment of anterior communicating artery aneurysm

报告前交通动脉瘤35例,占同期颅内动脉瘤的25%。30例行颅内动脉瘤直接手术,其中动脉瘤颈结扎或夹闭术21例,动脉瘤切除术5例,动脉瘤包裹术4例。大多数病人采用经单额纵裂入路,在显微外科技术下至少可保留一侧嗅觉。本组总死亡率为10%,0～Ⅲ级病人无死亡。本文对前交通动脉瘤直接手术的技术及术后并发症的预防进行讨论。

35 cases of anterior communicating are reported. It accout for 25% in all cerebral aneurysms admitted atthe same period.In 30 cases,direct surgery were com-plished which included ligation or clip of aneurysmalneck in 21 cases,resection of aneurysm in 5 cases andwrapping of aneurysm in 4 cases.In majority of pa-tients,unilateral transfrontal craniotomy and inter-hemispheric approach were used and operative mi-croscopy was used during surgery.Overall operativemortality rate was 10%.No death in O—Ⅲ Hess andHunt grade patients.A brief discussion about diagno-sis,operative technique,and prevention of complica-tions was made.