烟雾病合并动脉瘤的临床诊治探讨

目的探讨烟雾病合并动脉瘤的临床特点及治疗方法。方法回顾性分析10例经全脑血管造影证实的烟雾病合并动脉瘤患者的临床资料。结果10例患者巾9例表现为颅内出血，1例表现为脑缺血。烟雾病合并的动脉瘤9例位于Willis动脉环附近，为主要动脉型动脉瘤。其中5例行动脉瘤夹闭术，3例行血管内栓塞治疗，均恢复良好；1例基底动脉梭形动脉瘤和1例脉络膜前动脉动脉瘤（外周动脉型动脉瘤）无法手术。结论烟雾病合并动脉瘤可导致不同类型的颅内出血，对主要动脉型动脉瘤可进行外科手术治疗，对外周动脉型动脉瘤目前尚无理想治疗方法，可予以对症保守治疗。

Analysis of Clinical Diagnosis and Treatment of Intracranial Aneurysms Associated with Moyamoya Disease

Objective To explore the clinical characteristics and treatment of intracranial aneurysms associated with Moyamoya disease. Methods The clinical data of 10 patients with intracranial aneurysm associated with Moyamoya disease confirmed by cerebral angiography were analysed retrospectively. Results Of the 10 patients with intracranial aneurysm associated with Moyamoya disease, 9 suffered from intracranial hemorrhage, and 1 from cerebral ischemia. One case of anterior choroidal artery aneurysm which was peripheral artery type one and one case of basic artery aneurysm were conservatively treated. Of 8 cases of major artery aneurysms around Willis circles, 5 were clipped microsurgically and 3 were treated by endovascular embolization. The curative effect was good in 8 patients undergoing surgery, and endovascular embolization. Conclusions The intracranial aneurysms associated with Moyamoya disease may result in different types intracranial hemorrhage. The major artery aneurysm should be treated by surgical procedures and the peripheral artery type aneurysm should be conservatively treated because no appropriate surgical method to treat it was available now.