小脑上动脉动脉瘤的治疗体会

目的：探讨小脑上动脉动脉瘤的临床特点及治疗方法和效果。方法回顾性分析5例小脑上动脉囊性动脉瘤患者的临床资料。3例采用血管内介入治疗的患者中，2例使用支架辅助弹簧圈技术栓塞，1例单纯弹簧圈栓塞；2例行开颅夹闭术的患者，其中1例经颞下入路，1例经翼点入路。结果除1例经颞下入路开颅夹闭的患者术后遗留同侧动眼神经麻痹外，其余患者无神经功能障碍，痊愈出院；术后随访3～18个月，未见动脉瘤复发，无再出血病例。结论小脑上动脉动脉瘤发病率较低，临床表现以后循环蛛网膜下腔出血为主，可以根据具体情况采用血管内治疗或开颅手术，血管内治疗具有微创、疗效好和并发症少等特点，可以作为首选治疗方法。

Treatment experience of superior cerebellar aneurysms

Objectives To explore the clinical characteristics,therapies and effects of superiorcerebellar aneurysms（SCA）.Method Five cases of SCA were analyzed retrospectively.Among the threecases treated with endovascular embolization,two were embolized with stent assisted coiling and one wasoccluded with simple coiling.In the two cases treated with craniotomy for aneurysm clipping,one wasclipped via subtemporal approach and the other one via peterional approach.Result One patient with an eurysm clipping via peterional approach had oculomotor nerve paralysis,but the other patients recoveredwell and discharged.There we no recurrence or cerebral hemorrhage during the follow up period（3 to 18months）.Conclusion The incidence of superior cerebellar aneurysms is low and its main clinical mani festation is subarachnoid hemorrhage.Both of endovascular treatment and craniotomy are the alternativetreatments for SCA.Because of the advantages of minimal invasion,high safety and few complications,en dovascular treatment may become the primary management.