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无蛛网膜下腔出血的大脑中动脉动脉瘤破裂
引用本文:梁玉敏,潘耀华,殷玉华,刘卫东,包映晖,高国一,徐巳奕,万杰青,徐纪文,江基尧.无蛛网膜下腔出血的大脑中动脉动脉瘤破裂[J].国际外科学杂志,2007,34(4):226-229.
作者姓名:梁玉敏  潘耀华  殷玉华  刘卫东  包映晖  高国一  徐巳奕  万杰青  徐纪文  江基尧
作者单位:1. 200127,上海,上海交通大学医学院仁济医院神经外科
2. 200125,上海,上海浦东新区浦南医院神经外科
摘    要:目的总结无蛛网膜下腔出血(SAH)的大脑中动脉(MCA)动脉瘤破裂的临床特点。方法对6例在首次CT扫描上表现为脑内出血(ICH),或壁内出血(IMH)而无SAH的MCA动脉瘤破裂患者的临床表现、影像学检查、治疗方法和预后进行回顾性总结。结果本组首次CT扫描时间为起病后0—2d,表现为单纯ICH者4例,IMH者2例。DSA和手术证实为MCA动脉瘤破裂。开颅动脉瘤切除1例,夹闭5例,其中4例同时行血肿清除术。术后无死亡。结论MCA动脉瘤破裂首次CT扫描可仅表现为ICH或IMH而无SAH,与动脉瘤的部位、出血量以及CT扫描时间相关。

关 键 词:动脉瘤  脑内出血  壁内出血  大脑中动脉  蛛网膜下腔出血
修稿时间:2006-12-25

Ruptured middle cerebral artery aneurysms without subarachnoid hemorrhage
LIANG Yu-Min,PAN Yao-Hua,YIN Yu-Hua,LIU Wei-Dong,BAO Ying-Hui,GAO Guo-Yi,XU Si-Yi,WAN Jie-Qing,XU Ji-Wen,JIANG Ji-Yao.Ruptured middle cerebral artery aneurysms without subarachnoid hemorrhage[J].International Journal of Surgery,2007,34(4):226-229.
Authors:LIANG Yu-Min  PAN Yao-Hua  YIN Yu-Hua  LIU Wei-Dong  BAO Ying-Hui  GAO Guo-Yi  XU Si-Yi  WAN Jie-Qing  XU Ji-Wen  JIANG Ji-Yao
Institution:Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China; 2Department of Neurosurgeny, Punan Hospital, Shanghai 200125, China
Abstract:Objective To summarize the clinical features of ruptured middle cerebral artery (MCA) aneurysms without subarachnoid hemorrhage(SAH). Methods We retrospectivdy reviewed the clinical manifestations, neuroradiological examination, treatment and prognosis of 6 cases of ruptured MCA aneurysm presented as intracerebral hemorrhage(ICH) or intramural hemorrhage (IMH)without SAH on initial CT scanning. Results The initial CT scanning was obtained on 0-2 days after onset. IMH was showed in 2 cases and simple ICH was in 4 cases, of which 3 were located in temporal lobe and 1 in frontal lobe. All cases were identified as MCA aneurysm by DSA and operation. Aneurysm was resected in 1 case and clipped in 5 cases, of which hematoma was also evacuated in 4 cases. Of these patients, 5 cases were good recovery, and 1 case was in moderate disability. Conclusions Ruptured MCA aneurysm may only present as ICH or IMH without SAH. It relates to the location of aneurysm, the amount of hemorrhage and the time of CT scanning after onset.
Keywords:aneurysm  intracerebral hemorrhage  intramural hemorrhage  middle cerebral artery  subarachnoid hemorrhage
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