摘要
目的探讨颅脑损伤性假设动脉瘤的诊断与治疗要点,为挽救患者生命和提高生活质量提供参考。方法回顾性分析2011年7月至2013年2月期间收治的23例颅脑损伤性假性动脉瘤患者的临床资料,并对其诊断及治疗状况进行总结和分析。结果 23例患者均经全脑血管造影确诊为颅内假性动脉瘤,颅脑损伤性假性动脉瘤患者颅脑损伤后突发头痛20例,反复大量鼻衄2例,反复癫痫大发作3例,另外15例检查认定为颅内血肿8例、自发性蛛网膜下腔出血7例。假性动脉瘤位置为:6例在颈内动脉海绵窦段,5例在颈内动脉床突上段,4例在颈内动脉A2段,8例在颈内动脉床突旁段。23例患者均采用开颅切除载瘤动脉、覆膜支架、支架辅助弹簧圈栓塞、弹簧进行栓塞。术后12月随访发现痊愈19例且均无并发症。其余4例有2例偏瘫,2例死亡。结论利用全脑血管造影技术有助于确诊颅脑损伤性假性动脉瘤。开颅手术和血管内栓塞在治疗颅脑损伤性假性动脉瘤有着突出的作用,其中后者更有利于促进患者脑部功能恢复进度。
Objective To explore the important points of diagnosis and treatment of pseudoaneurysm caused by craniocerebral injury, and to provide the reference for saving the life of patients and improving their quality of life. Methods The clinical data of 23 patients with traumatic craniocerebral pseudoaneurysm in this hospital during the period of July 2011 to February 2013 were retrospectively analyzed and summarized about their diagnosis and treatment. Results The whole cerebral angiogram of these 23 eases demonstrated the presence of intracranial pseudoaneurysm, their symptoms including paroxysmal headache after craniocerebral injury in 20 patients, repeated large amount of epistaxis in 2 cases, repeated grand mal epilepsy in 3 cases. The examination revealed that intracranial hematoma in 8 of other 15 cases and spontaneous subarachnoid hemor- rhage in 7 of them. The locality of pseudoaneurysm in 6 patients was in cavernous sinus segment of internal carotid artery, in the bed of internal ca- rotid artery in 5 cases, in the upper section A2 of internal carotid artery in 4 cases, and at the side of internal carotid artery bed in 8 cases. The removal of parent artery by craniotomy, coated stents, stent assisted coil embolization and embolization with spring had been performed in 23 pa- tients. The postoperative follow - up at 12 months after the operation found recovery in 19 cases and no complication occurred. Among the remai- ning 4 cases, hemiplegia occurred in 2 patients and 2 cases died. Conclusion The application of whole cerebral angiogram technique is beneficial in diagnosis of traumatic cerebral pseudoaneurysm, craniectomy and endovascular embolization have been applied in treatment of this disease, and it is more advantageous to promote the recovery of brain function in these patients.
出处
《临床和实验医学杂志》
2013年第22期1824-1827,共4页
Journal of Clinical and Experimental Medicine
关键词
颅脑损伤
颅内假性动脉
瘤全脑血管造影
开颅手术
血管内栓塞
Craniocerebral injury
Intracranial pseudoaneurysms
Whole cerebral angiogram technique
Craniectomy
Endovascular em-bolization
