颅内后循环动脉瘤显微外科直视下手术治疗（附12例报告）

目的：探讨颅内后循环动脉瘤的手术治疗。方法：后循环动脉瘤12例，基底动脉交叉处为6例，大脑后动脉为3例，小脑下前、下后动脉为2例，基底动脉为1例。其中Hunter—Hess分级，Ⅰ级4例，Ⅱ级2例，Ⅲ级2例，Ⅳ级1例，Ⅴ级1例。结果：12例患者，8例痊愈，2例轻度神经功能障碍，2例重残，1例死亡。结论：后循环动脉瘤，手术难度大，入路选择，术中脑保护，临时阻断载瘤动脉，合理处理动脉瘤，亚低温深低温停循环应用，才能取得好效果。

THE DIRECT MICROSURGERY OF POSTERIOR CIRCULATION INTRACRANIAL ANEURYSMS(A REPORT OF 12 CASES)

Objective：To explore the clinical features, microsugical treatment stategy and therapeutic effect of posterior circulation intracranial aneurysms. Methods：Of the 12 aneurysms, 6 were at the tips of basilar artery, 3 in posterior cerebral artery, 1 in the basilar artery, 2 in the anterior and posterior inferior cerebellar artery. According to Hunter-Hess grade, of 11 patients when being admitted, 4 were in grade Ⅰ , 2 in grade Ⅱ, 2 in Ⅲ, 1 in Ⅳ, 1 in Ⅴ. The aneurysm neck was clipped successfully in 10 patients, 3 were clipped and reseeted, the angioplasty was performed in 1. Results： Of 12 patients, 8 returned to normal , 2 had mild neurological defect, 2 were severely disabled and 1 died . Conclusion：The microsurgery for intracranial aneurysms in the posterior circulation is very difficult; proper surgical approach, procedures of temporary occlusion of parent arteries, brain protection and hypothermic circulatory arrests should be used to achieve satisfactory result.