摘要
目的探讨外伤性颅内假性动脉瘤的临床表现、病理特点、影像学特征、治疗及预后。方法患者男性,34岁,因车祸致重型闭合性颅脑损伤,表现为大量脑内血肿和脑室、蛛网膜下腔出血。经急诊头颅CT、CTA和DSA检查拟诊为左侧大脑前动脉远端假性动脉瘤,并行外科手术治疗。结果术中清除血肿后证实左侧大脑前动脉远端分叉处血管裂伤,用10-0的尼龙线缝合了裂伤的血管壁。术后DSA复查假性动脉瘤消失且胼胝体缘动脉主干供血良好。考虑为大脑前动脉分叉处的剪切力造成了动脉裂伤。结论外伤性颅内假性动脉瘤罕见,易频发再破裂,致残率高,在颅脑损伤的临床诊治上需引起神经外科医生足够的重视。
Objective To explore the clinical manifestation, pathological and radiological characteristics, treatment and prognosis of traumatic intracranial pseudoaneurysm. Methods The neurosurgery was performed in a 34-year-old man with traumatic pseudoaneurysm of distal left anterior cerebral artery （ACA） suspiciously diagnosed as by CT, CTA, and DSA examination. The main imaging manifestations included massive intracerebral and intraventricular hemorrhage, and subarachnoid hemorrhage after the severe blunt closed head injury in the patient. Results The pseudoaneurysm of distal ACA was proved by the operation. The ruptured left distal ACA was successfully repaired after the removal of the hematoma. The postoperative DSA revealed that the pseudoaneurysm disappeared and the parent callosomarginal artery was free. Conclusions Traumatic intracranial pseudoaneurysm is uncommon. There is high morbidity in the patients with traumatic pseudoaneurysms due to frequent reputure. The great attention shoud be paid to the diagnosis and treatment of the pseudoaneurysms.
出处
《中国临床神经外科杂志》
2010年第10期594-596,共3页
Chinese Journal of Clinical Neurosurgery
关键词
颅脑损伤
假性动脉瘤
大脑前动脉
诊断
治疗
Head injury
Pseudoaneurysm
Anterior cerebral artery
Dianosis
Treatment
