创伤性颅内动脉瘤诊治体会

Experiences in the Diagnosis and Treatment of Traumatic Intracranial Aneurysms

【目的】创伤性颅内动脉瘤较为少见 ,由于对其缺乏足够认识使得其诊断往往在动脉瘤破裂出血导致严重后果时才做出。【方法】作者回顾近十年来收治 3例创伤性颅内动脉瘤 ,其中 2例分别于轻伤后 17、2 4d出现蛛网膜下腔出血 (SAH) ,脑内出血和脑室内出血 ,实施显微外科手术 ;另 1例轻伤后 5周出现颈内动脉海绵窦瘘 ,应用血管内球囊栓塞技术。【结果】3例均治愈 ,随访正常。【结论】结合相关文献复习 ,作者认为头部外伤后 ,特别是在突然出现神经系统症状加重应考虑动脉瘤可能 。

Objectives]To get the early diagnosis and understand the clinical features of traumatic intracranial aneurysms (TIA). Owing to their rare incidence,accurate diagnosis is usually made after rupture and bleeding of aneurysm leading to severe outcome.Three cases of TIA admitted and treated in our hospital over the last 10 years were reviewed retrospectively. Subarachnoid hemorrhage (SAH),intracerebral and intracerebro-ventricular hemorrhages occurred in two cases 17 and 24 days after mild injury to their heads, respectively. They were treated with microsurgery.One patient presented symptoms of carotid-cavernous fistula 5 weeks after mild head injury.He was treated by endo-vascular detachable balloon techruique.Better therapeutic efficacy was obtained in all 3 cases.[Conclusions]Based on the review of relevant literatures, it is suggested that TIA should be considered particularly when aggravation of neurological symptoms suddenly occurs following external trauma on head. Early diagnosis and surgical intervention may possess important significance in the prevention of adverse outcome caused by aneurismal rupture and bleeding.