翼点入路显微手术夹闭P1P2段大脑后动脉瘤4例

Microsurgical techniques of clipping of 4 cases aneurysm of the posterrior cerebral artery on P1P2 segment via Transpterional Approach

目的回顾分析4例P1P2段大脑后动脉瘤手术,探讨P1P2段大脑后动脉瘤的显微手术治疗的效果。方法本组4例均为自发性蛛网膜下腔出血。Hunt-HessⅠ-Ⅱ级2例,Ⅲ级1例,Ⅳ级1例。4例自发性蛛网膜下腔出血患者入院行头颅MRA检查,后进一步DSA检查明确。手术采用翼点入路。结果 4例患者均成功夹闭动脉瘤。术后影像学复查显示动脉瘤消失,无脑缺血表现。1例有动眼神经麻痹。随访2～12个月,恢复良好3例,植物生存1例。结论经翼点入路显微外科手术是治疗P1P2段大脑后动脉瘤的有效方法。

Objective 4 cases of aneurysm of the posterrior cerebral artery on P1 P2 segment performed mierosvrgery were analysed retrospectively, probe the effect of microsur gery for the aneurysm of the posterrior cerebral artery. Methods Of these 4 cases of aneurysm of the posterrior cerebral suffered hemorrhage. Accord- ing to Hunt-Hess grade, of 26 patients when being hospitalized, 2 cases were in grade Ⅰ- Ⅱ conditions and 1 case in grade Ⅲ, and 1 case in grade Ⅳ. All cases were diagnosed by DSA or MRA. Transpterional approach were adopted for all patients. Results 4 cases were completely clipped by aneurysm clips, the aneurysm disap- peared from the postoperative image, and no ischemic infarction. 1 cases showed oeulomotor palsy. In the 2 to 12-month follow -u p,3 cases recovered well, 1 cases in Vegetative state,no death in all the 4 cases. Conclusion The microsurgery of aneurysm of the posterrior cerebral artery on P1P2 segment via Transpterional Approach is a effective method.