颈眼动脉瘤外科处理的进一步探讨

Further study on the surgical management of carotidophthalmic aneurysms.

作者报告近来收治的8例病人共11个颈眼动脉瘤的经验。其中女性6例,平均年龄43岁,大和巨型动脉瘤6个。蛛网膜下腔出血为主要表现,视力、视野变化仅见3例。脑血管造影、CT和MRI是本病的主要诊断方法。全部病人手术治疗,计动脉瘤夹闭6个、切除1个,颈内动脉慢性阻断1个,动脉瘤孤立伴颅内外动脉吻合1个,包裹1个,1个无症状小动脉瘤未手术。无手术死亡。随访1～6年(平均3.5年),优6人,良2人。结果表明,手术时在脑保护剂的应用下,暂时阻断颈动脉和切除前床突及部分视神经管,有利于动脉瘤的夹闭。

Eight patients with 11 of carotidophthalmic aneurysms (CophAAs) werereported, their averaged age was 43 yea-rs old, 6 patients female, large and gi-ant types of CophAAS in 6 cases. Subar-achnoid hemorrhage was primary manif-estation, visual deficits appeared only in3 patients. Angiography, CT scan andMRI were major diagnostic means forthe patients. All patients underwent mi-crosurgical operations, including aneury-sm neck clipping in 6, aneurysm resec-tion 1, gradual internal carotid occlusion1, aneurysm trapping with intra andextracranial artery bypass 1, aneurysmwrapping 1. One case (having no sym-ptoms) with small aneurysm was notoperated. All the surgical operations we-re successful. Follow-up for a period of1-6 years (mean 3.5 years) was carried out with excellent in 6 cases, good 2.It was suggested that during the opera-tion, uses of brain protection agent, tem-porary carotid occlusion, removal ofanterior clinoid process and partial opticcanal would benefit for aneurysm clipping.