小脑后下动脉动脉瘤的特点与血管内治疗  

Characteristics and endovascular treatment of posterior inferior cerebellar artery aneurysms

作　　者：李志清[1] 梁国标[1] 王晓刚[1] 高旭[1] 张海峰[1] 于春泳[1] 赵明利[1] 许晓川[1] 陈忠志 赖杰宇 

机构地区：[1]沈阳军区总医院神经外科 全军神经医学研究所,110840 [2]解放军202医院神经外科,沈阳110003

出　　处：《中国微侵袭神经外科杂志》2015年第1期4-6,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：科技部"十二五公关"课题(编号:2011BAI08B06);辽宁省科技公关课题(编号:2011225021);辽宁省自然科学基金(编号:201403714)

摘　　要：目的总结小脑后下动脉动脉瘤（posterior inferior cerebellar artery aneurysms,PICAA）的临床和影像学特征,并探讨血管内治疗的安全性、有效性和操作技巧。方法回顾性分析37例PICAA病人的临床资料。术前死亡1例,36例存活病人中9例行微弹簧圈栓塞术,12例行支架辅助微弹簧圈栓塞,15例行Onyx栓塞术。结果术后恢复良好34例（GOS〉5分）,1例留有吞咽困难,1例残留小脑性共济失调。2例因脑积水行侧脑室外引流。随访36例,时间3个月～5年,无再出血。27例复查DSA,复发1例。结论 PICAA造成的蛛网膜下腔出血有典型的影像和临床表现。早期行DSA检查和血管内治疗,疗效满意。Objectives To summarize the clinical and imaging characteristics of posterior inferior cerebellar artery aneurysms（PICAA） and explore the safety,efficacy and operation techniques of endovascular treatment.Method Clinical data of 37 patients with PICAA were analyzed retrospectively.One patient died before surgery,9 received microcoil embolization,12 stent-assisted microcoil embolization and 15 Onyx embolization.Results Good recovery was achieved in 34 patients（ GOS 5）,dysphagia remained in 1 and cerebellar ataxia in 2.Two patients received external drainage of the lateral ventricle due to hydrocephalus.Thirty-six patients were followed up for 3 months to 5 years,and no rebleeding was found.DSA was reperformed in 27 patients and relapse occurred in 1.Conclusions There are typical imaging and clinical manifestations in subarachnoid hemorrhage caused by PICAA.Early DSA and endovascular treatment can obtain satisfactory surgical outcome.

关 键 词：颅内动脉瘤 小脑后下动脉 蛛网膜下腔出血 血管内治疗 

分 类 号：R651.12[医药卫生—外科学]