目的 探讨大脑中动脉动脉瘤破裂伴血肿的临床特点及手术治疗效果。方法 对32例大脑中动脉动脉瘤破裂伴血肿患者的临床资料进行回顾性分析。结果 所有患者均在神经电生理联合监测下急诊行开颅血肿清除并动脉瘤夹闭术,出院时根据GOS评分:4～5分23例,3分5例,2分2例,1分2例,出院后随访30例,随访时间3个月～6年,未见动脉瘤复发及再出血。结论 神经电生理监测下尽早行开颅血肿清除并夹闭动脉瘤,可提高疗效。
Abstract
Objective To explore the clinical characteristics, diagnostic value and curative effect of three-dimensional CT angiography (3D-CTA) in middle cerebral artery aneurysms associated with hematoma.Methods The clinical data of thirty-two patients with middle cerebral artery aneurysms associated with hematoma was analyzed retrospectively.Results All the patients received craniotomy for evacuation of hematoma and clipped intracranial aneurysms under neuroeletrophysiological monitoring. When the patients were discharged, they were graded according to Glasgow Outcome Scale.Twenty-three patients got 4-5 scores, five patients 3 scores,two patients 2 scores, and two patients got 1 score. The follow-up ranged from three months to six years, and there was no recurrent aneurysm or re-bleeding postoperatively.Conclusions The three-dimensional CT angiography (3D-CTA) is a preferred method to diagnose ruptured middle cerebral artery aneurysms associated with hematoma. Early craniotomy for evacuation of hematoma and clipped intracranial aneurysms under neuroeletrophysiological monitoring can improve the therapeutic effect.
关键词
颅内动脉瘤 /
大脑中动脉 /
血肿 /
显微外科手术
Key words
intracranial aneurysm /
middle cerebral artery /
hematoma /
microsurgery
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