瘤壁钙化颅内动脉瘤的手术治疗

目的报告16例瘤壁有钙化的颅内动脉瘤病例的治疗,分析颅内血管钙化与颅内动脉瘤病理发生机制的关系.方法回顾性分析16例瘤壁有钙化的颅内动脉瘤病例的影像学、临床资料及手术治疗.结果瘤壁有钙化的颅内动脉瘤的位置是:3例位于后交通动脉,2例位于大脑中动脉,2例位于前交通动脉,5例位于椎动脉,4例位于基底动脉.所有患者血钙、磷酸盐、血糖、肾功能正常.6例患者血脂增高.16例患者均行动脉瘤夹闭术,其中8例术中切除动脉瘤,治疗效果良好.结论动脉瘤瘤壁钙化与其病理发生机制有关,常见于巨大或大动脉瘤,瘤壁血管钙化是与动脉粥样硬化、血钙、磷酸盐、血脂、甲状腺、甲状旁腺等因素有关的主动耗能,多因素调控的病理过程.

Surgical management of intracranial aneurysms with aneurismal wall calcification

Objective To report 16 cases of intracranial ane ur ysms with calcified vascular wall and study the relationship between vascular ca lcification and pathogenic mechanism of intracranial aneurysms.Methods Spiral CT scan, clinical data and serum calcium, phosphate, glucose, lip id, renal function of the 16 patients were studied in retrospect. All aneurysms were clipped, in which 8 were resected after clipping.Results The location of aneurysms with aneurismal wall calcification was, on posterio r communicating artery in 3, on middle cerebral artery in 2, on anterior com municating artery in 2, on basilar artery in 5 and on basilar artery in 4 . All patients showed normal serum calcium, phosphate, glucose and normal renal func tion. Serum lipid of patients had been elevated. All patients recovered with n o significant neurological deficits.Conclusion Intracranial vascular calcification is an active and regulated process in close relation to atherosclerosis, serum calcium, phosphate, lipid, thyroid, parathyroid function and other factors. Intracranial vascular calcification has close relationshi p with the pathogenesis and management of intracranial aneurysms.