未破裂脑动脉瘤的手术预后。苏黎世大学医院40例报告。

Surgical prognosis of unruptured cerebral aneurysms. Report of 40 cases in University Hospital Zurich.

作者信息

Ishihara H, Yoshimura S, Könü L, Khan N, Yonekawa Y

机构信息

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.

出版信息

Acta Neurochir Suppl. 2002;82:35-9. doi: 10.1007/978-3-7091-6736-6_7.

DOI:10.1007/978-3-7091-6736-6_7

PMID:12378988

Abstract

A series of 40 patients admitted to University Hospital Zurich (1996-97) with unruptured cerebral aneurysms is reported. Fifty-two aneurysms were treated in 40 operations. The age of surgically treated patients ranged from 31 to 78 year old (mean 53.6). The main locations of the aneurysms were: MCA 21 (40.4%), AcomA 10 (19.2%), ICA (posterior communicating and bifurcation) 6 (11.5%), carotid-ophthalmic segment 4 (7.7%), ACA 4 (7.7%), basilar tip 3 (5.8%), vertebral artery 2 (3.8%). The circumstances of diagnosis were: incidental 15 (37.5%), other cranial lesions 9 (22.5%), symptomatic 8 (20%), multiple aneurysm 8 (20%). The overall outcome of surgery was: good recovery in 39 cases (97.5%), moderately disabled in 1 case (2.5%) who was 56 year-old and had three aneurysms including basilar tip. There was no operative mortality. Though this series has small number of patients, it suggests that location of the aneurysm is an important factor affecting surgical outcome among patient age, the circumstances of the diagnosis, size and location of aneurysm.

摘要

本文报告了苏黎世大学医院（1996 - 1997年）收治的40例未破裂脑动脉瘤患者的情况。40例手术共治疗了52个动脉瘤。接受手术治疗的患者年龄在31岁至78岁之间（平均53.6岁）。动脉瘤的主要位置分布如下：大脑中动脉（MCA）21个（40.4%），前交通动脉（AcomA）10个（19.2%），颈内动脉（后交通和分叉处）6个（11.5%），颈内动脉眼段4个（7.7%），大脑前动脉（ACA）4个（7.7%），基底动脉尖3个（5.8%），椎动脉2个（3.8%）。诊断情况如下：偶然发现15例（37.5%），其他颅脑病变9例（22.5%），有症状8例（20%），多发动脉瘤8例（20%）。手术总体结果为：39例（97.5%）恢复良好，1例（2.5%）中度残疾，该患者56岁，有3个动脉瘤，包括基底动脉尖处的动脉瘤。无手术死亡病例。尽管该系列患者数量较少，但这表明在患者年龄、诊断情况、动脉瘤大小和位置等因素中，动脉瘤位置是影响手术结果的重要因素。