显微外科手术治疗颅内前循环直径小于等于2mm微小动脉瘤的疗效

目的观察显微外科手术治疗颅内前循环直径≤2 mm微小动脉瘤的临床疗效。方法回顾性分析2010年6月—2012年3月,中国医科大学附属第一医院神经外科采用显微神经外科手术治疗的19例(34个动脉瘤)颅内前循环动脉瘤患者的临床资料。34个动脉瘤中,21个为微小动脉瘤,对其中19个微小动脉瘤进行了显微神经外科手术治疗。19个微小动脉瘤中,9个为破裂动脉瘤,10个为未破裂动脉瘤。单发颅内微小动脉瘤的6例患者,均以蛛网膜下腔出血(SAH)起病。随访手术治疗微小动脉瘤的疗效。结果使用迷你动脉瘤夹成功夹闭18个微小动脉瘤(9个破裂,9个未破裂),使用颞浅筋膜片包裹1个大脑中动脉未破裂微小动脉瘤。出院时采用格拉斯哥预后量表(GOS)评分,5分17例,4分2例。平均随访14.1个月,未发生再次SAH。15例在出院后3～6个月复查DSA,未见动脉瘤复发。结论采用迷你动脉瘤夹夹闭微小动脉瘤的显微神经外科手术治疗颅内前循环微小动脉瘤是安全有效的。

Microsurgical treatment of intracranial anterior circulation minute aneurysms(2 mm or smaller)

Objective To observe the clinical efficacy of Microsurgical treatment of intracranial an- terior circulation minute aneurysms （ ≤ 2 mm in diameter）. Methods The clinical data of 19 patients with intracranial anterior circulation aneurysms （34 aneurysms） treated with microsurgery from July 2010 to March 2012 at the Department of Neurosurgery, the First Affiliated Hospital, China Medical University were analyzed retrospectively. Of the 34 aneurysms, 21 were minute aneurysms, and 19 of them were treated with microsurgery. Of the 19 minute aneurysms, 9 were ruptured and the other 10 were un- ruptured. The onset attach of 6 patients with single intracranial minute aneurysms was SAH. The effi- cacy of Microsurgieal treatment of minute aneurysms was followed up. Results Eighteen minute an- eurysms （9 ruptured and 9 unruptured） were clipped successfully with mini aneurysm clips. An unrup- tured minute aneurysms at the middle cerebral artery was wrapped with superficial temporal fascia. At the time of discharge, The Glasgow outcome scale （GOS） scores in 17 patients were 5, and in 2 were 4. The mean follow-up period was 14. 1 months, no subaraehnoid hemorrhage recurred. After dis- charge, 15 patients had DSA reexamination at 3 to 6 months after discharge, and no aneurysm recur- rence was observed. Conclusion Microsurgical clipping of intracranial anterior circulation minute aneurvsms is safe and effective.