床突下颈内动脉瘤的手术治疗

Surgical treatment infraclinold aneurysms of internal carotid artery

本文报告12例床突下颈内动脉瘤,其中颈内?眼动脉瘤和海绵窦内动脉瘤各6例。小型2例,大型4例,巨型6例。4例为多发性动脉瘤。本组2例未治,死亡1例。6例采用保守性手术,死亡2例。采用手术显微镜下直视手术4例:3例治愈,1例术后造影夹闭良好,动脉瘤消失,但合并严重脑血管痉挛和脑梗塞死亡。

In this paper 12 cases of infraclinoid aneurysmsof internal carotid artery have been reported.which included 6 carotid-ophthalmic aneurysms and 6intracavernous aneurysms. There were 2 cases of smalltype. 4 cases of large type and 6 of giant type.Multiple aneurysms were in 4 cases. The neck of giantaneurysmc usually not visualized with routine an-giography but they were seen clearly with cinoan-giography in our 2 cases.There were 6 cases treatedbefore 1982 with conservative operation and 2died. An other one died from bleeding withoutoperation. 4 cases were treated by neck clippingunder operating-microscope. and 3 cases cured.There was. giant aneurysm which diameter was upto 9 cm. During operation, aneurysmal wall wasincised, blood clots removed. after clearly locatedthe internal opening of the aneurysmal neck clip-ped from external wall. and finally wall suturedfolded successfully. In another case of intracaver-nous aneurysm. The neck was clipped directlyafter inclsion of cavernous from Parkinsion's trian-gle. Postoperative angiography showed the clip welllocated and the aneurysm disvisulized. But patientdied from complicated severe cerebrovasospasm andinfarction of cerebral hemisphere.