单侧翼点入路一期夹闭术治疗颅内前循环倒影动脉瘤

One-stage microsurgery via unilateral pterional approach for patients with multiple intracranial anterior circulation aneurysms locating on both sides of the parent arteries like mirror image

目的探讨单侧翼点入路一期夹闭术治疗颅内前循环倒影动脉瘤的方法及疗效。方法回顾性分析2014年7月至2019年10月经单侧翼点入路一期夹闭术治疗的7例颅内前循环倒影动脉瘤的临床资料。结果7例共19个动脉瘤,均一期手术成功夹闭;术后复查CTA显示动脉瘤瘤颈完全夹闭,载瘤动脉通畅。3例术中动脉瘤再次破裂。术后出现脑积水1例,行脑室-腹腔分流术后好转。未出现脑梗死及颅内感染等。术后随访3个月~3年,根据GOS:恢复良好5例,中残1例,重残1例。结论颅内前循环倒影动脉瘤可选择单侧翼点入路一期手术夹闭治疗,手术成功率高,预后良好。

Objective To investigate the clinical efficacy of one-stage microsurgery via unilateral pterional approach for the patients with multiple intracranial anterior circulation aneurysms locating on both sides of the parent arteries like mirror image(named as mirror image aneurysms).Methods The clinical data of 7 patients with mirror image aneurysms locating at the intracranial anterior circulation who underwent one-stage microsurgery via unilateral pterional approach from July 2014 to October 2019 were retrospectively analyzed.Results All 19 aneurysms of 7 patients were completely clipped in one stage operation.Intraoperative rebleeding occurred in3 patients.Postoperative hydrocephalus occurred in 1 patient.There was no postoperative cerebral infarction and intracranial infection.The follow up ranging from 3 moths to 3 years showed GOS score of 5 in 5 patients,score of 4 in 1 and score of 3 in 1.Conclusions For patients with with mirror image aneurysms locating at the intracranial anterior circulation,one-stage microsurgery via unilateral pterional approach is a good treatment method,which has high rate of surgical success and good prognosis.