经翼点入路显微手术夹闭治疗大脑前循环动脉瘤

目的:探讨经翼点入路显微手术夹闭治疗颅内动脉瘤的方法。方法:应用显微神经外科技术,对12例颅内动脉瘤患者进行直视手术。经翼点入路,以Mayfield头架固定头部,取自耳屏前方、颧弓上缘至中线发际内做弧形切口。根据需要充分显露载瘤动脉后,再解剖瘤颈。结果:12例颅内动脉瘤手术夹闭成功,以格拉斯哥预后评分量表对患者神经功能评分,评分好的10例,差的1例,死亡1例。结论:经翼点入路,应用显微外科技术,手术路径最短,视野角度最大,是治疗大脑前循环动脉瘤的经典入路。

12 cases of front circulation aneurysms nip close under microsurgical treatment via pterional approach

Objective:To summarize the microsurgial technique of pterional approach in treating for front circulation aneurysms.Methods:12 patients of front circulation aneurysms were reviewed retrospectively.The technique of pterional approach for the microsurgical treatment was summarized in several aspects:(1)the selection of the operation time;(2)the management of aneurysm rupture during the operation;(3)the prevention and treatment of blood vessel spasm in post-operative period.Glasgow outcome scale(GOS)wase used to evaluate the postoperative neurofunction of patients.Results:All aneurysms were clipped successfully.Good outcomes(GOS scores is 4 or 5)were achieved in 10 patients,poor outcomes(GOS scores is 2 or 3)in 1 patient,and death l patient.Conclusions:Good outcome can be achieved in patients with aneurysms who accepted microneurosurgery viapterional approach at early stage.