小脑前下动脉瘤11例临床分析

目的总结小脑前下动脉瘤的临床和影像学特点,以及手术夹闭与介入治疗两种方法的治疗效果。方法回顾性分析首都医科大学附属北京天坛医院神经外科2012年1月-2019年12月收治的小脑前下动脉瘤患者的基线信息、临床表现、动脉瘤特点、治疗方式和治疗效果。结果共收治11例小脑前下动脉瘤患者,其中显微外科手术夹闭动脉瘤5例,治愈率100%,术后2例(40%)出现不完全性失语和手术侧面瘫,随访均无复发;介入治疗6例,5例(83.3%)完全栓塞动脉瘤,其中2例(33.3%)闭塞动脉瘤远端载瘤动脉,1例(16.7%)栓塞治疗失败,术后1例(16.7%)出现记忆力下降,1例(16.7%)出院1个月后动脉瘤破裂,并最终死亡。结论对于小脑前下动脉瘤,积极干预对于挽救患者生命意义重大,开颅手术夹闭和介入治疗都是可选的治疗方式,两者均效果确切。

Clinical Analysis of 11 Cases of Anterior Inferior Cerebellar Artery Aneurysms

Objective To summarize the clinical characteristics of 11 cases of anterior inferior cerebellar artery
(AICA) aneurysms and compare the efficacy of two treatment approaches of neurosurgical clipping
and endovascular coiling.
Methods Clinical data of patients with AICA aneurysms admitted to Department of Neurosurgery,
Beijing Tian Tan Hospital, Capital Medical University from 2012 January to 2019 December were
retrospectively analyzed. The clinical data included the baseline information, clinical presentation,
aneurysm feature, treatment way and clinical outcome.
Results A total of 11 cases were included, including 5 cases with neurosurgical treatment and 6
cases with endovascular treatment. The surgical success rate of neurosurgery group was 100%, with
no recurrent aneurysms during the follow-up period, and partial aphasia and operation-ipsilateral
facioplegia occurred in 2 cases (40%) after operation. Of 6 cases with endovascular treatment, there
were 5 cases of successful endovascular coiling and 1 failure case, 1 of 5 successful cases died from
re-ruptured aneurysm at 1 month after discharge, and dysmnesia occurred in 1 case after operation.
Conclusions Both neurosurgical clipping and endovascular coiling are feasible and effective
treatment approaches for patients with AICA aneurysms.