颅内多发动脉瘤的显微手术治疗

Microsurgical treatment of multiple intracranial aneurysms

目的 总结颅内多发动脉瘤显微手术的经验。 方法 回顾性分析 8例 17个颅内动脉瘤的临床资料。 结果 对患者随访半个月～ 10年 ,按Sundt的随访结果评定标准评定 :5例满意 ,2例好转 ,1例死亡 (为双侧后交通动脉瘤术后 1周 )。 结论 颅内多发性动脉瘤可尽早一期手术 ,特别是双侧动脉瘤患者 ,采用冠状切口双侧翼点入路 ,先夹闭容易出血侧的动脉瘤 ,再夹闭另外一侧为宜。此入路具有创伤小、暴露好 。

Objective To summarize the experience in microsurgical treatment of multiple intracranial aneurysms. Method Eight patients with 17 aneurysms were analysed retrospectively. Results Seven patients were followed up from 0 5 month to 10 years. According to Sundt′s standard, the results in 5 patients were excellent and 2 good. One patients with bilateral PCom aneurysm died 1 week after operation. Conclusions Multiple intracranial aneurysms should be removed as soon as possible, especially bilateral ones. The best way is first to clip the bled aneurysm and then the contralateral one by using coronal incision and bilateral pterional approach. This approach has the advantage of minimal invasion, good exposure, and less time consuming.