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颅内感染性动脉瘤的治疗:16例病例系列

Management of intracranial infectious aneurysms: a series of 16 cases.

作者信息

Phuong Loi K, Link Michael, Wijdicks Eelco

机构信息

Department of Neurosurgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

出版信息

Neurosurgery. 2002 Nov;51(5):1145-51; discussion 1151-2. doi: 10.1097/00006123-200211000-00008.

Abstract

OBJECTIVE

The purpose of this study was to better define the management of intracranial infectious aneurysms.

METHODS

We present a retrospective review of the management of 16 patients with intracranial infectious aneurysms. The mean follow-up period was 86 months.

RESULTS

None of the patients had a rehemorrhage during antibiotic treatment. The mortality and long-term outcome from ruptured intracranial infectious aneurysms may be better than previously thought. There was no significant difference in long-term outcome between patients with single or multiple infectious aneurysms or between patients who underwent surgical resection and those who were treated only with antibiotics.

CONCLUSION

Operative treatment should be pursued for patients with ruptured infectious aneurysms. Patients with unruptured intracranial infectious aneurysms should be observed during antibiotic therapy and followed up with cerebral angiography. Surgical resection should be considered if the aneurysm enlarges and the patient's general medical condition allows general anesthesia to be tolerated.

摘要

目的

本研究的目的是更好地明确颅内感染性动脉瘤的治疗方法。

方法

我们对16例颅内感染性动脉瘤患者的治疗情况进行了回顾性分析。平均随访时间为86个月。

结果

在抗生素治疗期间,无一例患者再次出血。颅内感染性动脉瘤破裂后的死亡率和长期预后可能比之前认为的要好。单发或多发感染性动脉瘤患者之间,以及接受手术切除的患者与仅接受抗生素治疗的患者之间,长期预后无显著差异。

结论

对于破裂的感染性动脉瘤患者应进行手术治疗。未破裂的颅内感染性动脉瘤患者在抗生素治疗期间应进行观察,并通过脑血管造影进行随访。如果动脉瘤增大且患者的一般身体状况能够耐受全身麻醉,则应考虑手术切除。

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