首发为眼部症状的脑动脉瘤临床分析

Cinical Analysis of Cerebral Aneurysms with Ocular Features as Primary Symptom

目的探讨首发为眼部症状的脑动脉瘤临床诊断和处理时机,提高临床诊治水平。方法收集2003—2008年我院收治首发为动眼神经麻痹症状的脑动脉瘤患者42例,分别行头颅CT、磁共振、全脑血管造影检查,确诊后给予开颅动脉瘤颈夹闭术和DSA血管内介入微弹簧圈动脉瘤栓塞术治疗。结果26例动眼神经不全麻痹患者术后完全恢复达84.6%,14例动眼神经全麻痹患者术后完全恢复达35.7%,部分恢复达64.3%。2例瞳孔中度散大患者,术后完全恢复。结论首发症状为动眼神经麻痹者,应考虑到脑动脉瘤的可能性。及时发现并给予相应治疗,是挽救患者生命,促进动眼神经恢复的关键措施。

Objective To investigate preoperative diagnosis and suzgieal opportunity of cerebral aneurysms with ocular, features, as primary symptom, to increase clinical diagnosis and treatment level. Methods The study was a retrospective analysis of 42 subjects with cerebral aneurysms, from 2003 to 2008, who presented oculomotor nerve palsy and were diagnosed by CT, MRI and digital subtraction angiography. They received clipping of the aneurismal neck or microcoil embolization combined endovascular DSA. Resuits Twenty-six patients with incomplete oculomotor nerve palsy were operated and showed complete recovery of the oculomotor nerve function after operation （84.6%） ; 14 patients with complete oculomotor nerve palsy were operated showed complete recovery of the oculomotor nerve function （35.7%） and partially recovery （64.3%） ; 2 patients with mydriasis showed complete recovery after operation. Conclusion The patients with oculomotor nerve palsy as primary symptom ought to be suspicious of intracranial aneurysm. Early diagnosis and treatment help save the life and make the oculomotor nerve function recover.