大脑中动脉M1段动脉瘤手术治疗体会

目的探讨大脑中动脉M1段动脉瘤特点及显微手术夹闭的技巧和预后。方法总结我科20例不同级别大脑中动脉M1段动脉瘤,在不同时期均采用经翼点入路显微镜下行动脉瘤夹闭。结果动脉瘤均行夹闭,手术后死亡2例,病人发生颞叶大面积脑梗死;出院时格拉斯哥预后评分(GOS)优良10例,中度残4例,重度残3例,植物状态1例。结论大脑中动脉M1段动脉瘤预后差,致残率高,容易发生大面积脑梗死,早期手术及灵活的手术技巧以及术后高灌注和预防脑血管痉挛是改善预后的有效手段。

The M1 segment of middle cerebral artery aneurysm characteristics and surgical treatment

Objective To investigate the clinical characteristic,microsurgical treatment and prognosis of the M1 segment of middle cerebral artery aneurysm.Methods Clinical data of the 20 patients with M1 segment of middle cerebral artery aneurysms in different levels treated by microsurgical treatment in different period were retrospectively analyzed.Results All aneurysms were clipped.After the operation,2 cases died of temporal lobe large area infarction.In all patients,the hospital Glasgow prognostic score(GOS)were good in 10 cases,moderate disability in 4 cases,severe disability in 3 case and plants survival in 1 case.Conclusions With poor prognosis,high morbidity,prone to large area cerebral infarction,the early surgery,flexible operation skills and postoperative high perfusion and prevent cerebral vasospasm can improve the outcome of the patients in the effective means.