摘要
目的探讨双侧大脑中动脉动脉瘤采用单侧翼点入路同侧夹闭方法的可行性。方法收集吉林大学白求恩第一医院神经血管病外科收治的14例双侧大脑中动脉动脉瘤患者的临床资料，手术采取单侧翼点入路同侧夹闭双侧大脑中动脉动脉瘤。术后行CTA或DSA复查，随访6～12个月。GOS评分评估预后。结果采用单侧翼点入路同侧夹闭双侧动脉瘤13例；另1例探查同侧大脑中动脉后排除动脉瘤，对侧动脉瘤予以夹闭。对侧动脉瘤≤5mm的患者14例，中动脉长度〉14mm的患者3例，动脉瘤指向脑岛2例，合并载瘤动脉硬化的患者7例，均给予夹闭。术后GOS评分均为5分，头部CTA或DSA检查未见动脉瘤复发。结论单侧翼点入路同侧夹闭双侧大脑中动脉动脉瘤具有可行性。但应主要考虑脑组织水肿、对侧动脉瘤大小、动脉瘤体指向、载瘤动脉是否含有动脉硬化，以及对侧M1的长度。
Objective To Investigate the feasibility of clipping of bilateral aneurysms of middle cerebral arteries （MCA） through unilateral pterional approach. Methods The clinical data of 14 cases of bilateral MCA aneurysms were collected. The head CTA or DSA examination after operation and during the follow-up period （6 -12 months） were reviewed. Finally the GOS scores were evaluated. Results 13 cases of patients were treated by unilateral pterional approach for the treatment of bilateral aneurysms of MCA. In 1 case, the ipsilateral aneurysm was excluded and the contralateral aneurysm was clipped. The size of all the aneurysms was less than 5mm. The contra - arteries of M1 were more than 14mm in 3 cases. The aneurysms pointed to insular lobe in 2 cases and 7 cases had the parent artery atherosclerosis. All the aneurysms were clipped. The postoperative GOS was 5 in all the patients. The postoperative head CTA or DSA examination showed that there was no aneurysm recurrence. Conclusions It was feasible for clipping of bilateral aneurysms of MCA through unilateral pterional approach. But the brain edema, contra - lateral aneurysm size, arterial aneurysm point, parent artery atherosclerosis and the length of the opposite M1 should be considered.
出处
《中华神经外科杂志》
CSCD
北大核心
2014年第4期381-383,共3页
Chinese Journal of Neurosurgery
关键词
颅内动脉瘤
单侧入路
大脑中动脉
双侧
显微外科手术
Cerebral aneurysms
Unilateral approach
Middle cerebral artery
Bilateral
Microsurgery
