颅内多发动脉瘤的外科治疗(附16例报告)

Surgical treatment of multiple intracranial aneurysms(A report of1 6 cases)

目的 :探讨颅内多发动脉瘤的发生率、治疗原则和预后。 方法 :分析我科手术治疗的颅内动脉瘤 2 0 6例 ,其中颅内多发动脉瘤 16例 ,占总数的 7.8%。 15例有两个动脉瘤 ,1例有 3个动脉瘤。 33个动脉瘤中 ,后交通动脉瘤占 75.8% ,眼动脉瘤占 12 .1% ,前交通动脉瘤和大脑中动脉动脉瘤分别占 9.1%和 3.0 %。均有蛛网膜下腔出血史。一期手术处理所有动脉瘤 14例 ,分期手术处理 2个动脉瘤 1例 ,另 1例仅处理 1个动脉瘤。 结果 :优良 15例 ,轻残 1例。 结论 :尽可能一期手术处理所有动脉瘤 。

Objectives:To explore the incidence,principles of treatment and the prog- nosis of multiple intracranial aneurysms(MIA) . Methods:Of the2 0 6 cases of intracranial aneurysms operated upon during the past2 0 years in our department,1 6 (7.8% ) presented with MIA,1 5 had two aneurysms and 1 had three aneurysms. Among 33aneurysms,2 5 (75 .8% ) were located in the posterior communicating artery,4(1 2 .1 % ) in the ophthalmic artery,3(9.1 % ) in the anterior communicating artery,and 1 (3.0 % ) in the middle cerebral artery.All presented with subarachnoidal haemorrhage(SAH) .One- stage operations were performed in1 4cases,two- stage operation in1 and just one aneurysm was operated upon in the remaining 1 case. Results:Recovery was excellentor good in 1 5 cases,mild disability in 1 case. Conclusions:Prognosis is good for multiple aneurysms treated in one- stage opera- tions and the strategy should be applied whenever possible.