Department of Neurosurgery, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan 250012, China.
J Clin Neurosci. 2011 Dec;18(12):1639-44. doi: 10.1016/j.jocn.2011.03.034. Epub 2011 Oct 21.
Vertebral artery dissecting aneurysms (VADA) are challenging disorders for neurosurgeons. Between December 2005 and May 2010, we treated 12 patients for DA of the intracranial VA. Three were treated by open surgery, seven underwent endovascular manipulation, and two were conservatively managed. Nine patients presented with subarachnoid hemorrhage from the ruptured aneurysm, and of these, two experienced abrupt re-hemorrhage and three presented with symptoms of brainstem ischemia. One of the two patients with a re-hemorrhage underwent conservative management and died in hospital of re-bleeding at 30 days after initial presentation. No postoperative neurological deficits occurred in patients treated by open surgery or via an endovascular approach. No re-hemorrhage or ischemic symptoms were observed in the 11 remaining patients during the mean 29-month (range: 14-54-month) follow-up. The chosen management strategy should be developed according to the patient's clinical condition and imaging results. Endovascular treatment, which includes several techniques, is the first choice for most patients.
颅内椎动脉夹层动脉瘤（VADA）是神经外科医生面临的挑战。2005 年 12 月至 2010 年 5 月，我们治疗了 12 例颅内 VA 的 DA 患者。3 例行开放手术治疗，7 例行血管内操作，2 例保守治疗。9 例患者因破裂的动脉瘤蛛网膜下腔出血就诊，其中 2 例发生再出血，3 例出现脑干缺血症状。2 例再出血患者中，1 例接受保守治疗，在初次发病后 30 天死于再次出血。开放手术或血管内治疗的患者均无术后神经功能缺损。11 例患者在平均 29 个月（范围：14-54 个月）的随访中无再出血或缺血症状。选择的治疗策略应根据患者的临床状况和影像学结果制定。血管内治疗，包括几种技术，是大多数患者的首选。
