Wong George Kwok Chu, Tang Hoi Bun, Poon Wai Sang, Yu Simon Chun Ho
Division of Neurosurgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Surg Neurol Int. 2010 Dec 22;1:84. doi: 10.4103/2152-7806.74145.
Data suggests that hemorrhagic presentations occur in 20% of internal carotid artery dissections and 50% of vertebral artery dissections. A Finnish study has reported favorable outcomes in only 32% of patients. We aimed to review the epidemiology and management outcomes in a Chinese population.
We reviewed the aneurysmal subarachnoid hemorrhage registry of patients who presented with intracranial dissecting aneurysms at a neurosurgical center in Hong Kong over a five-year period.
A total of 23 patients with intracranial dissecting aneurysms were identified, accounting for 8% of all spontaneous subarachnoid hemorrhage patients. Forty-eight percent of the patients identified were treated by main trunk occlusion and 39% were treated by embolization or stent-assisted embolization or stent alone. Thirteen percent were managed by craniotomy and trapping or wrapping. Favorable outcomes at six months were achieved in 67%.
Patients with intracranial dissecting aneurysms account for a significant proportion of the cases of spontaneous subarachnoid hemorrhage in our population. Carefully selected endovascular and microsurgical treatments can lead to management outcomes similar to patients with saccular aneurysms.
数据表明，20%的颈内动脉夹层和50%的椎动脉夹层会出现出血表现。一项芬兰研究报告称，只有32%的患者预后良好。我们旨在回顾中国人群中的流行病学和治疗结果。
我们回顾了香港一家神经外科中心在五年期间颅内夹层动脉瘤患者的动脉瘤性蛛网膜下腔出血登记情况。
共识别出23例颅内夹层动脉瘤患者，占所有自发性蛛网膜下腔出血患者的8%。48%的确诊患者接受了主干闭塞治疗，39%接受了栓塞或支架辅助栓塞或仅置入支架治疗。13%通过开颅夹闭或包裹治疗。67%的患者在六个月时获得了良好的预后。
颅内夹层动脉瘤患者在我国自发性蛛网膜下腔出血病例中占相当大的比例。精心选择的血管内治疗和显微外科治疗可导致与囊状动脉瘤患者相似的治疗结果。
