多发性颅内动脉瘤临床报告并文献复习

A Report and Literature Review of Intracranial Multiple Aneurysms

目的探讨多发性颅内动脉瘤(multiple intracranial aneurysms,MIA)的临床特点及手术方式选择。方法对分别选择介入栓塞手术和开颅夹闭手术治疗的MIA 2例的临床资料进行回顾性分析,并复习相关文献。结果 2例分别因头痛伴恶心、呕吐1 h余和头痛伴左眼睑下垂、左眼视物模糊12 d入院。经相关检查2例均诊断MIA,且动脉瘤均5个。经综合分析患者个人状况、病史及临床资料等情况,2例分别选择介入栓塞手术和开颅夹闭手术进行治疗,均手术顺利。术后1例头颅数字减影血管造影检查显示5个动脉瘤全部栓塞,1例头颅螺旋CT动脉造影检查示动脉瘤夹固定在位,管腔未见狭窄。2例术后随访1年和3个月均病情稳定。结论综合分析各种因素选择最适宜的治疗方案,是MIA成功治疗的关键。

Objective To investigate clinical features and surgical methods of multiple intracranial aneurysms( MIA). Methods Clinical data of 2 MIA patients,which had respectively selected interventional embolization and craniotomy closed surgery,was retrospectively analyzed,and related literature was reviewed. Results Two patients were admitted for headache associated by nausea and vomiting for more than 1 h,and headache associated by left blepharoptosis and left eye blurred vision for 12 d respectively. The two patients were diagnosed as having MIA by related examinations,and aneurysms number was 5. Personal conditions,case history and clinical data were comprehensively analyzed,and then the two patients were treated with interventional embolization and craniotomy closed surgery respectively,and the surgeries were both successful. Postoperatively cranial digital subtraction angiography showed that all the 5 aneurysms were embolized in one patient. Cranial spiral CT angiography showed that the aneurysm was fixed in place without stenosis in the lumen in another patient. Conditions of the two patients were stable with postoperative follow-up for 1 year and 3 months. Conclusion The key for successful treatment of MIA is selection of the most suitable treatment for various factors by comprehensive analysis.