儿童颅内外伤性动脉瘤的诊治  

Diagnosis and treatment of traumatic intracranial aneurysm in childhood

作　　者：俞炬明[1] 范国平[1] 钟伟兴[1] 张永平[1] 彭海腾[1] 朱铭[1] 程永德[2] 

机构地区：[1]上海交通大学医学院附属新华医院放射科,200042 [2]《介入放射学杂志》编辑部

出　　处：《介入放射学杂志》2008年第8期552-554,共3页Journal of Interventional Radiology

摘　　要：目的评价儿童颅内外伤性动脉瘤的诊断、介入治疗疗效和安全性。方法分析5例有明确头颅外伤史患儿颅内外伤性动脉瘤病例。经CT、MRI检查,2例为外伤性蛛网膜下腔出血,2例分别表现为右枕部颅内出血及左颞部颅内出血,另1例为后颅凹少量出血伴天幕缘少量硬膜下出血,右侧侧脑室三角区少量出血。5例患儿经DSA全脑血管造影分别诊断为左颈内动脉C1段外伤性动脉瘤,右侧裂动脉分支外伤性动脉瘤,左大脑中动脉分支外伤性动脉瘤,右大脑后动脉远端外伤性动脉瘤,右小脑后下动脉外伤性动脉瘤。其中左颈内动脉C1段外伤性动脉瘤和右侧裂动脉分支外伤性动脉瘤经GDC栓塞术治疗,左大脑中动脉分支外伤性动脉瘤及右小脑后下动脉外伤性动脉瘤手术夹闭。另1例严密随访观察。结果2例外伤性颅内动脉瘤经GDC栓塞术及2例外伤性动脉瘤手术均获成功,未留任何后遗症;5例均能正常的学习和生活。结论儿童颅内外伤性动脉瘤虽属罕见,但GDC及手术治疗儿童颅内动脉瘤安全而有效,长期预后则有待于随访观察。Objective To evaluate the diagnosis, safety and efficacy of interventional therapy and surgery for child traumatic intracranial aneurysms. Methods Five patients with traumatic intracranial aneurysms including three males and two females, age ranged from 2 to 10 years old; 5 had undertaken CT and MR scanings. All of them showed traumatic subarachnoid hemorrhage in 2, intracerebral hematoma in the right occipital and the left temporal respectively in 2 and another one with somewhat bleeding at the posterior fossa and right trigone of lateral ventricles and subdural bleeding at the tentorium edge. The detailed vascular involvement diagnosis were made by DSA revealing one of left C1 segmental internal carotid artery traumatic aneurysm, one of the branch of right sylvian artery traumatic aneurysm, one of left middle cerebral artery traumatic aneurysm, one of left posterior cerebral artery traumatic aneurysm, one of the branch of right posterior inferior cerebellar artery traumatic aneurysm. Two of them were treated by embolization therapy with GDC and two by surgery. Results The GDC embolization in 2 cases and the surgical operation for another 2 were all succeeded without death or complications. The last case was followed up closely. Conclusions Traumatic intracranial aneurysm is rare in childhood but endovascular treatment with GDC and surgery is efficient and safe, yet the long-term efficacy is still relied on follow-up.

关 键 词：外伤性动脉瘤 儿童 数字减影血管造影 

分 类 号：R743.4[医药卫生—神经病学与精神病学]