前交通动脉瘤二次破裂致脑室出血的治疗

Treatment of anterior communicating artery aneurysm with second broking to ventricular hemorrhage

目的 探讨合并脑室出血前交通动脉瘤的临床特点及手术时机.方法 回顾性分析11例脑室出血的前交通动脉瘤病例的临床资料.结果 所有病人中有8例第二次出血后经额叶或纵裂透明隔或终板破入脑室,二次出血为1～3d后,10例行动脉瘤夹闭术,5例预后良好,3例较差,2例死亡.结论 前交通动脉瘤在发生蛛网膜下腔出血可再次出血,通过额叶或纵裂透明隔或终板破入脑室,提示早期处理动脉瘤的必要性.

Objective To study the clinical characteristic and timing of surgery of ruptured anterior communicating artery aneurysm with ventricular hemorrhage （ Hunt-Hess IV, V ）. Methods The clinical data of 11 patients with anterior eommunicating artery aneurysm with ventricular hemorrhage were analyzed retrospectively. Results Of 11 patients, 8 had the second hemorrhage broking into the ventricle through frontal lobe or septum pellucidum or lamina terminalis, interval time of bleeding was 1 to 3 days, and 10 aneurysms was cliped , 6 prognosis was good, 3 was poorer and 2 died. Conclusion Ruptured anterior communieating artery aneurysm may broke secondly and bleeding into ventricular through the frontal lobe or septum pellueidum or lamina terminalis, thereby causing serious consequences, suggests that the early operation was important.