以脑内血肿伴侧裂区少量出血为首发CT表现的大脑中动脉瘤的诊治体会

Diagnosis and treatment of middle cerebral artery aneurysms with intracranial hematoma and small amount of hemorrhage in the lateral fissure as first CT findings

目的探讨以脑内血肿伴侧裂区少量出血为首发CT表现的大脑中动脉瘤的诊断及治疗。方法12例脑内血肿伴侧裂区少量出血的患者11例经CTA检查后发现大脑中动脉瘤,其中1例直接手术探查发现大脑中动脉瘤,全部患者经Yasargil翼点入路行动脉瘤夹闭术。结果GOS评分:治愈(5分)4例(33.3%);自理(4分)6例(50.0%);重残或植物生存(3~2分)2例(16.7%);死亡(1分)0例。结论及时有效的诊断、娴熟的手术技术是提高以脑内血肿伴侧裂区少量出血为首发CT表现的大脑中动脉瘤治疗效果的关键。

Objective To investigate the diagnosis and treatment of middle cerebral artery aneurysms with intracranial hematoma and small amount of hemorrhage in the lateral fissure as first CT findings. Methods Middle cerebral artery aneurysms were found by CTA examination in 11 of 12 patients with intracerebral hematoma and small amount of hemorrhage in the lateral fissure, a case of middle cerebral artery aneurysms was found by surgical exploration. All patients underwent aneurysm clipping surgery by Yasargil pterional approach. Results GOS score: 4 cases (33.3%) were cured (5 points);6 cases (50.0%) were self-care (4 points);2 cases (16.7%) were severely disabled or plant survival (3 to 2 points);without death case (1 point). Conclusion Timely and effective diagnosis and skilled surgical technique are necessary to improve the treatment effect of middle cerebral artery aneurysms with intracranial hematoma and small amount of hemorrhage in the lateral fissure as first CT findings.