非出血型烟雾病合并动脉瘤的临床特征及治疗预后

Clinical features and outcomes of non-hemorrhagic moyamoya disease with intracranial aneurysm

目的探讨非出血型烟雾病合并动脉瘤的临床特征、治疗及预后。方法回顾性分析12例确诊为非出血型烟雾病合并动脉瘤病人的临床资料。12个动脉瘤中,主要动脉型动脉瘤11个,周围动脉型动脉瘤1个,均属小型动脉瘤(直径小于5 mm)。病人均行脑-硬膜-颞浅动脉血管融通术(encephalo-duro-arterio-synangiosis,EDAS),动脉瘤予随访观察。结果术后8例行脑血管造影随访6~72个月,结果发现1例周围动脉型动脉瘤消失,7例主要动脉型动脉瘤大小及形状无变化。所有病人临床随访4~90个月,均未发生脑卒中。m RS评分1分5例,0分7例。结论非出血型烟雾病合并动脉瘤大多属主要动脉型,且属于小型动脉瘤,此类动脉瘤可暂不直接处理。EDAS术后动脉瘤可长期稳定,部分周围动脉型动脉瘤可消失。

Objective To investigate the clinical features and outcomes of non-hemorrhagic moyamoya disease with aneurysm.Methods Clinical data of 12 patients of non-hemorrhagic moyamoya disease with intracranial aneurysm were analyzed retrospectively.There were 12 intracranial aneurysms, including 11 aneurysms at major arteries and 1 aneurysm at peripheral artery. The sizes of all aneurysms were less than 5 mm. All the patients received encephalo-duro-arterio-synangiosis（EDAS） and follow-up observation was performed on all the aneurysms. Results Eight patients were followed up for 6 to 72 months by DSA examination and 7 patients with major artery aneurysm remained stable and 1 peripheral artery aneurysm disappeared. All patients received clinical followed-up for 4 to90 months, no stroke occurred. The modified Rankin Scale（m RS） score was 1 point in 5 patients and zero in 7. Conclusions Most of aneurysms in patients of non-hemorrhagic moyamoya disease with aneurysms are major artery type, and all aneurysms are small, do not need treatment at first. Most aneurysms remain stable after EDAS, and some peripheral artery aneurysms may disappear.