烟雾病合并颅内动脉瘤的临床特点及血管内治疗（附七例报告）  

Clinical features and endovascular treatment of moyamoya disease with intracranial aneurysms

作　　者：杨洪宽[1] 赵亚军[1] 陈如东[1] 何跃[1] 于加省[1] 陈劲草[1] 陈坚[1] 雷霆[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030

出　　处：《中华神经外科杂志》2015年第6期568-571,共4页Chinese Journal of Neurosurgery

基　　金：武汉市科技局科技攻关计划重点基金（200960323130）

摘　　要：目的 探讨烟雾病合并颅内血流相关性动脉瘤的临床影像学特征以及血管内栓塞治疗的方法.方法 回顾性分析7例经由DSA确诊并经血管内栓塞治疗的烟雾病合并颅内动脉瘤患者的临床表现特点、影像学特征以及血管内栓塞治疗方法,其中2例于栓塞术后行脑室外引流术,1例行颞肌贴敷术,1例行颅内外血管搭桥术及颞肌贴敷术.结果 7例患者中5例表现为蛛网膜下腔出血,2例表现为脑实质出血破入脑室;7例患者的8个动脉瘤中6例为主要动脉型动脉瘤,2例为外周动脉型动脉瘤,均行血管内栓塞治疗,术后患者临床症状均有不同程度的恢复或改善,其中5例患者可正常工作学习,1例患者轻度偏瘫但生活自理,1例患者有较重的一侧下肢运动障碍,生活基本自理,DSA随访复查未见复发及新发动脉瘤.结论 烟雾病所致血流相关性动脉瘤导致不同类型的临床表现及影像学表现,血管内栓塞技术是治疗烟雾病血流相关性动脉瘤的有效方法.Objective To investigate the clinical imaging features and methods of endovascular embolization of moyamoya disease with intracranial blood flow-related aneurysms.Methods The clinical features,imaging features and endovascular embolization treatment of 7 patients with moyamoya disease and intracranial aneurysm diagnosed by digital subtraction angiography （DSA） were analyzed retrospectively.Two of them underwent ventricular drainage after embolization,1 underwent roofing of temporal muscle,and 1 underwent extra-and intra-cranial vascular bypass and roofing of temporal muscle.Results Five of 7 patients showed subarachnoid hemorrhage,2 showed cerebral parenchymal hemorrhage broken into ventricles ; of the 7 patients with 8 aneurysms,6 were the main artery aneurysms and 2 were peripheral artery aneurysms.They were all treated with endovascular embolization.The clinical symptoms of the patients had different degrees of recovery or improvement,5 of them could work and learn normally,1 had mild hemiplegia,but he could take care of himself,1 patient had severer lower limb movement disorder on one side and he could almost take care of himself.No recurrence and new aneurysms were found after following up with DSA.Conclusion Blood flow-related aneurysms cause by moyamoya disease may result in different types of clinical and imaging manifestations.Endovascular technique is an effective method for the treatment of blood flow-related moyamoya disease.

关 键 词：烟雾病 动脉瘤 血管内治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]