显微外科治疗基底动脉顶端动脉瘤

Microsurgery treatment with aneurysm on the top of basilar artery

目的探讨基底动脉顶端动脉瘤的显微外科治疗方法及效果。方法对2007年5月至2010年9月首都医科大学附属复兴医院手术治疗的8例基底动脉顶端动脉瘤进行分析。其中男5例，女3例。年龄42～58岁，平均52．6岁。6例病人动脉瘤直接夹闭，2例动脉瘤累及大脑后动脉，行颞浅动脉一桡动脉一大脑后动脉搭桥，动脉瘤夹闭术。结果按Glasgow结果评分（cos）进行术后评分，术后7例患者恢复良好，1例搭桥病人动眼神经不全瘫痪同术前，中残。结论基底动脉动脉瘤手术困难，并发症多，选择适当显微外科治疗方法，亦可取得良好的治疗效果。

Objective To explore the efficacy and method of microsurgery for aneurysm on the top of basilar artery. Methods The investigators analyzed retrospectively the clinical data of 8 microsurgical patients with aneurysm on the top of basilar artery from May 2007 to September 2010. There were 5 males and 3 females with an average age of 52. 6 years old. Six of 8 cases underwent clipping of aneurysm while other 2 patients received superficial temporal artery-radial artery-posterior cerebral artery bypass grafting surgery and clipping of aneurysm. Results On the basis of GOS （ Glasgow outcome score）, the postoperative recovery was excellent in 7 patients. And 1 patient suffered insufficiency of oculomotor nerve similarly as preoperatively. Conclusion The surgical procedures for aneurysm of basilar artery are so complicated as to lead to many complications. A wise choice of operative approaches may yield a better outcome.