伴有颅内血肿的前循环破裂出血动脉瘤超早期显微手术治疗

目的 探讨伴有颅内血肿的前循环破裂出血动脉瘤超早期显微手术治疗.方法 27例前循环动脉瘤破裂伴颅内血肿形成患者24 h内行显微手术治疗,探讨其影像学特点、手术方法.结果 27例术中诊断与术前一致,责任动脉瘤为前交通动脉瘤6例,后交通动脉瘤8例,大脑中动脉瘤13例.多发动脉瘤3例,2例位于同侧前循环,1次手术夹闭,1例另1枚动脉瘤位于对侧大脑中动脉分叉处,择期手术处理.出血动脉瘤均为中小型动脉瘤.术后GOS分级Ⅴ级14例,Ⅳ级9例,Ⅲ级2例,Ⅰ级2例.结论 前循环动脉瘤破裂伴颅内血肿形成超早期显微手术清除血肿,夹闭动脉瘤,效果满意.

Abstract：

Objective To explore ultra - early microsurgical management in patients with ruptured aneurysms of anterior circlulation combined with intracerebral hematoma. Method The imaging characteristics and operation methods of 27 cases of ruptured aneurysms of anterior circlulation combined with intracerebral hematoma underwent surgery within 24 hours were collected. Results The surgical outcomes indicated that the intraoperative diagnoses were consistent with preoperative diagnoses in all cases. The rupture aneurysms include 6 cases of anterior communicating artery aneurysms,8 posterior communicating artery aneurysms,and 13 middle cerebral artery aneurysms. There were 3 patients harbored two aneurysms,2 in homolateral anterior circulation clipped at the same time, 1 in contralateral middle artery clipped in another operation. The aneurysms were all middle or small size. The postoperative Glasgow Outcome Scales (GOS) were grade Ⅴ in 14 patients,grade Ⅳ in 9, grade Ⅲ in 2, grade Ⅰ in 2. Conclusions For patients with ruptured aneurysms of anterior circlulation combined with intracerebral hematoma, favorable outcome chould be achieved through ultra - early microsurgical management

Ultra - early microsurgical management for patients with ruptured aneurysms of anterior circlulation combined with intracerebral hematoma

Objective To explore ultra - early microsurgical management in patients with ruptured aneurysms of anterior circlulation combined with intracerebral hematoma. Method The imaging characteristics and operation methods of 27 cases of ruptured aneurysms of anterior circlulation combined with intracerebral hematoma underwent surgery within 24 hours were collected. Results The surgical outcomes indicated that the intraoperative diagnoses were consistent with preoperative diagnoses in all cases. The rupture aneurysms include 6 cases of anterior communicating artery aneurysms,8 posterior communicating artery aneurysms,and 13 middle cerebral artery aneurysms. There were 3 patients harbored two aneurysms,2 in homolateral anterior circulation clipped at the same time, 1 in contralateral middle artery clipped in another operation. The aneurysms were all middle or small size. The postoperative Glasgow Outcome Scales (GOS) were grade Ⅴ in 14 patients,grade Ⅳ in 9, grade Ⅲ in 2, grade Ⅰ in 2. Conclusions For patients with ruptured aneurysms of anterior circlulation combined with intracerebral hematoma, favorable outcome chould be achieved through ultra - early microsurgical management