4例颅内巨大血栓性动脉瘤的病理和临床研究

Pathological and clinical studies of 4 cases of intracranial gigantic thromboaneurysm

目的：增强对颅内巨大血栓性动脉瘤的认识，提高临床诊治水平。方法：总结和分析４例巨大血栓性动脉瘤的病理和临床特点及两者关系。结果：２例延髓腹侧动脉瘤病人术后均死亡，另２例额部者均获成功切除。病理检查见动脉瘤壁厚达２～３ｍｍ，内容物为葱皮样层机化血栓。结论：颅内巨大血栓性动脉瘤有部分血栓和全部血栓两种，两者的处理方法不同，结果不同。应结合病灶大小、位置、病人年龄及病情等综合考虑，决定处理方法。

Purpose To add knowledge of the intracranial gigantic thromboaneurysm (IGTA) to clinical doctors and to improve their clinical ability of the diagnosis and treatment. Methods The pathological and clinical features of 4 cases of IGTA and the relationship betweer them were studied. Results Two patients with the leision at medullary bulb died after operation, while the other two with IGTA at frontal part of the brain were cured by operation. Pathological examination showed the aneurysms wall was 2 to 3 mm thick. The content in it was layers and layers of organized thrombi. Conclusions There are two kinds of IGTA, that is partly thrombus formation or totally thrombus formation. Different treatment should begiven to them according to comprehensive study of the site and size of aneurysm, the age and condition of the patient, etc.