颅内前循环巨大动脉瘤20例治疗体会

Experience of treating 20 cases with large intracranial anterior circulation aneurysm

目的总结颅内前循环巨大动脉瘤20例治疗体会。方法回顾性分析颅内前循环巨大动脉瘤20例患者的临床资料。其中,有头痛、头晕、视物模糊和意识障碍症状者17例,体检发现无症状者3例。动脉瘤位于颈内动脉眼动脉段4例,颈内动脉海绵窦段5例,颈内动脉床突上段3例,大脑中动脉8例。20例均行手术治疗,包括血管内治疗和/或显微手术。结果依据GOS评分,评定预后好17例,预后差(包括死亡)3例。结论颅内前循环巨大动脉瘤需依据具体病变情况行个体化治疗方案,例如显微手术、血管内治疗或两者联合治疗。

Objective To summarize the experience of treating 20 cases with large intracranial anterior circulation aneurysm.Methods Clinical data of 20 patients with intracranial anterior circulation aneurysm were retrospectively analyzed,of whom 17 cases were with symptoms of headache,dizziness,blurred vision,confusion of consciousness and 3 cases were diagnosed by physical examination and without clinical symptoms.The aneurysm located at C6 segment of internal carotid artery in 4 patients,at C4 segment of internal carotid artery in 5 cases,at C5 segment of internal carotid artery in 3 cases and at middle cerebral artery in 8 cases.All cases underwent intravascular therapy and/or microsurgery.Results According to Glasgow outcome scale score,17 cases were evaluated with good prognosis and 3 cases with poor prognosis including death.Conclusion Large intracranial anterior circulation aneurysm should be treated individualizedly according to specific pathological conditions,which includes simple microsurgery,intravascular therapy or microsurgery combined with intravascular therapy.