摘要
目的 探讨根据大脑中动脉动脉瘤（MCAA）的影像学分型,术中识别并保护外侧纹体动脉（LLA）对预防脑梗死的指导意义.方法 回顾性分析2006年12月至2013年6月收治74例,共89个大脑中动脉动脉瘤,依据影像学资料分为A型（前外侧型）52个,B型（后上型）28个和C型（内下型）9个.采用不同的分离技巧,术中皆成功分辨并保护LLA,动脉瘤夹闭86个,微动脉瘤电凝后包裹3个.随访按格拉斯哥预后评分（GOS）标准进行评分.结果 GOS 5分（治愈）66例,4分（轻偏瘫但自理）5例,3分（重残）2例,1分（死亡）1例.结论 依据动脉瘤影像学分型,采用个体化手术分离技巧,结合LLA的解剖特点,术中识别并保护LLA和夹闭动脉瘤,减少术后脑梗死的发生率.
Objecfive To evaluate the value of imaging classification of middle cerebral artery aneurysm on prevention of cerebral infarction during operation.Methods A total of 87 cases with 89 aneurysms were classified into 3 types according to the angiographical projections：type A with anterior-lateral projection in 52 aneurysms,type B with superior-posterior projection in 28 aneurysms and type C with inferior projection in 9 aneurysms.Eighty-six aneurysms were clipped,while the other 3 micro-aneurysms were coagulated and wrapped.All the lateral lenticulostriate arteries were well identified and protected.Results According to Glasgow outcome score,66 cases were 5,5 cases were 4,2 cases were 3 and 1 case was 1.Conclusion It was easier to identify and protect the lateral lenticulostriate artery and reduce the incidence of postoperative cerebral infarction by the guidance of preoperative imaging classification combined with the acknowledgement of the recurrent course of lateral lenticulostriate artery.
出处
《中华神经外科杂志》
CSCD
北大核心
2015年第5期458-460,共3页
Chinese Journal of Neurosurgery
关键词
大脑中动脉
颅内动脉瘤
显微外科手术
大脑梗塞
脑血管造影术
分类
Middle cerebral artery
Intracranial aneurysm
Microsurgery
Cerebral infarction
Cerebral angiography
Classification
