节点文献
颅内后循环动脉瘤
Intracranial aneurysms of the posterior cerebral circulation
【摘要】 目的:回顾性分析并探讨颅内后循环动脉瘤的临床表现和手术人路。方法:后循环动脉瘤22例,占同期颅内动脉瘤的10.3%,其中大脑后动脉瘤12例,基底动脉瘤6例,脉络膜后动脉远端动脉瘤2例,小脑前下动脉和小脑后下动脉瘤各1例。蛛网膜下腔出血15例(68.2%),其它表现为脑干和脑神经损害症状。18例经显微手术,主要经翼点人路和颞下经小脑幕人路。2例栓塞治疗,2例因病人拒绝未治。结果:动脉瘤夹闭加切除10例,孤立加切除6例,包裹2例,血管内治疗2例。18例优良,2例轻残,无手术死亡。结论:后循环动脉瘤大多瘤体较大,瘤内多含血栓。翼点人路对基底动脉远端、大脑后动脉P1+2段动脉瘤显露优良,颞下入路用于夹闭大脑后动脉P2~3段动脉瘤,显露优良。
【Abstract】 In order to analyse and explore the clinical manifestation and surgical approach of in-tracramal aneurysms of posterior circulation. Method: 22 patients with vertebrobasilar a-neurysms were treated in Xanjing General Hospital of PLA from 1979 to 1996,it accounts for 10.3% of all intracranial aneurysms, including the aneurysms of posterior cerebral artery in 12 cases, basilar artery in 6 cases, posterior choroidal artery in 2 cases, anterior inferior cerebellar artery and posterior inferior cerebellar artery in 1 case respectively. The subarachnoid hemorrhage was manifested in 15 cases (68. 2%). The other clinical manifestations were dysfunction of the brain stem and cranial nerve. The microsurgical technique were used via pterional approach or subtemporal approach in 18 cases. The aneurys-mal embolization were performed in 2 cases. Another 2 patients refused to be treated. Result: The aneurysms were clipped and resected in 10 cases, trapped and resected in 6 cases, and wrapped in 2 cases. The excellent curative effect was gained in 18 cases, 2 patients suffered from mild morbidity. There was no operative mortality. Conclusion: The most of aneurysms of posterior circulation were large in size, and always with thrombus in the aneurysmal sac. A good exposure field could be gained by pterional approach for the distal basilar artery and the P12 segment of posterior cerebral aneurysms. The subtemporal approach was suited for clipping the P23 segment of posterior cerebral aneurysms.
【Key words】 intracranial aneurysm vertebrobasilar artery subarachnoid hemorrhage microsurgery;
- 【文献出处】 中国微侵袭神经外科杂志 ,Chinese Journal of Minimally Invasive Neurosurgery , 编辑部邮箱 ,1998年03期
- 【分类号】R739.4
- 【被引频次】1
- 【下载频次】72