大脑后动脉瘤的直接手术(附5例报告)

Direct operation for posterior cerebral artery aneurysm (report of 5 cases)

本文报告大脑后动脉瘤(PCAA)5例,占同期颅内动脉瘤的4.0％。PCAA的临床特点是:(1)易形成巨大动脉瘤,约占80％;(2)临床表现以SAH最多见,且也常有局灶性症状,如偏瘫,动眼神经麻痹、同向偏盲等;(3)CT检查常可见大脑脚旁或颞叶内侧占位病变;(4)常伴有胎儿型PCA。最佳治疗是经颞下入路将动咏瘤夹闭或切除,并对PCA的显微外科解剖、手术方法和并发症进行了简要讨论。

5 cases of PCAA were reported, counting 4.0%。 intracranial aneurysms at the same period. The clinical features of PCAA included: forming giant aneurysm in about 80% cases; presenting SAH and induciag focal symptoms e. g. hemiparalysis, paralysis of oculomotor or hemianopsia; showing massive lesion around cerebral peduncule or internal temporal lobe on CT scan; being associated with a fetal PCA.The appropriate treatment was considered using the clip or resection of aneurysm from subtemporal approach. Brief disscusion on microsurgical anatomy of PCA, operative procedttres and surgical complications was made.