单侧入路治疗急性期颅内多发动脉瘤的一期手术治疗

To explore the treatment of single - stage unilateral neurosurgical approach to clip the multipleintracranial aneurysms in acute stage

目的探讨单侧入路一期手术夹闭急性期颅内多发动脉瘤的手术时机、方法及效果。方法回顾分析2011年1月至2012年11月18例38个颅内多发动脉瘤显微外科手术治疗患者的临床资料。18例均采取急性期一侧入路一期手术夹闭多发动脉瘤，原则是先处理破裂动脉瘤，再处理未破裂动脉瘤。结果38个动脉瘤均在急性期行一侧入路一期手术夹闭。术后恢复良好14例，轻度残疾2例，重度残疾1例，植物生存1例，无死亡病例。18例经3D-CTA和（或）DSA复查，未见动脉瘤残留或再通。结论正确判断责任动脉瘤并首先处理，根据动脉瘤的部位、患者身体状况等选择急性期一侧入路一期手术可达到良好效果。

Objective To explore the treatment of single - stage unilateral neurosurgical approach to clip the multiple intracranial aneurysms in acute stage, for the patient could avoid a second craniotomy and anesthesia. We present our technique of the single - stage unilateral approach to multiple intracranial aneurysms. Methods From January 2011 to November 2012, 18 patients with multiple intracranial aneurysms were single - stage unilaterally approached in acute stage. Results Total 38 aneurysms of 18 patients were successfully clipped in single- stage unilateral neurosurgical operation in acute stage. The patent of all parents＂ arteries were preserved. The 14 cases of 18 patients are fine, there was no death associated with this approach in our group. Conclusions The method of single - stage unilateral neurosurgical approach to clip the multiple intracranial aneurysms in acute stage can avoid the patients＂ risk and inconvenience associated with a separate craniotomy at the different stage. And it＇s very important ot judge the responsible aneurysms correctly before and in operation. Therefore, it is a good technique for MIA and a good alternative approach for neurosurgeons.