创伤性颅内动脉瘤的早期诊断及治疗  

Early angiographic diagnosis and treatment of traumatic intracranial aneurysms

作　　者：王道奎[1] 曲秉坤[1] 王寿先[1] 王增武[1] 王喆[1] 曹培成[1] 宋仁兴[1] 

机构地区：[1]山东潍坊市人民医院脑科医院神经外科,261021

出　　处：《中华神经外科杂志》2012年第8期826-828,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨创伤性颅内动脉瘤的早期诊断和治疗以及对改善预后的意义。方法前瞻性研究高度怀疑为创伤性颅内动脉瘤的42例外伤患者，早期行DSA检查，诊断明确的给予及时治疗。结果病情平稳后立即行DSA检查，检查在入院后1—7d，共发现8例创伤性颅内动脉瘤患者，8个动脉瘤，6例位于大脑前动脉分支，2例位于颈内动脉段。3例在破裂之前、5例在二次破裂之前行手术或介入治疗，其中3例行开颅手术治疗，5例行介入治疗。随访12个月，无再出血病例，无手术相关死亡病例，6例行DSA复查未见复发，2例因经济原因未行复查。术后肢体偏瘫加重1例，3个月时肢体肌力恢复正常。结论对于高度怀疑为创伤性颅内动脉瘤的患者，应早期行DSA检查，手术或介入治疗是治疗创伤性动脉瘤有效方法。Objective To study the early angiographic diagnosis and treatment of traumatic intracranial aneurysms （TICA）. Methods From Jan 2005 to Jun 2010, the diagnostic angiography was performed on 42 patients of craniocerebral trauma doubted to be TICA. And then the TICAs were treated by endovaseular or surgical techniques. Results 8 TICAs were diagnosed . Six aneurysms were located on branches of the anterior cerebral artery, and two internal carotid artery. 3 TICAs were treated before rupture and 5 before second rupture. 3 TICA were treated by surgery and 5 endovascular techniques. There was no recanalization was detected in 6 patients. Two patients refused angiographic follow - up. There was no patient presented with delayed bleeding （ mean follow - up duration ： 12 months ）. There was significant postoperative worsening in the contralateral extremities in one patient which improved within 3 months. There was no procedure - related complication or mortality. Conclusions Early angiographic diagnosis could provid an effective approach for TICA detection . Early endovascular or surgical therapy may allow early aneurysm exclusion with excellent results.

关 键 词：创伤性动脉瘤 诊断 治疗 

分 类 号：R651.1[医药卫生—外科学]