动脉瘤破裂致急性硬膜下血肿

Acute Subdural Hematoma Caused by Ruptured Cerebral Aneurysms

目的探讨动脉瘤破裂引起急性硬膜下血肿的诊断和治疗方法。方法回顾分析天坛医院神经外科近年来收治的9例动脉瘤破裂引起急性硬膜下血肿患者的病历资料。根据Glasgow评分来评价患者的意识情况,通过血管造影确定动脉瘤的发生部位,并行血肿清除和动脉瘤夹闭术治疗。结果4例患者术后完全恢复正常,无神经功能缺失。3例患者术后遗留不同程度的肢体活动障碍。2例患者术后死亡。结论动脉瘤破裂引起急性硬膜下血肿的情况少见且致命,对这类患者应进行及时的血肿清除和动脉瘤夹闭术。

Objective Acute subdural hematoma originating from ruptured cerebral aneurysms is rare. To investigate the diagnosis and management of this condition is the purpose of the article. Methods Nine cases of acute subdural hematoma due to cerebral aneurysm rupture confirmed by cerebral angiography and surgery were reviewed retrospectively. Patients were evaluated using the Glasgow Coma Scale（GCS） in terms of their consciousness. The original sites of the aneurysms repure were detected with DSA. Evacuation ot hematoma and clipping of aneurysms were performed in these patients. Results 3 cases recovered completely, 3 cases remained neurological deficiency, 2 cases died postoperatively. Conclusion Acute subdural hematoma due to ruptured cerebral aneurysm is rare and fatal. Timely subdural hematoma removal and aneurysml clipping surgery should be performed for such patients.