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胼周动脉动脉瘤的诊断与治疗

Diagnosis and treatment of pericallosal artery aneurysms.

作者信息

Sun Guo-Qing, Jin Shi-Gang, Fu Ting-Kai, Chen Xiang-Tao, Xu Zhen

机构信息

Department of Neurosurgery, Rizhao Peoples Hospital Affiliated to Jining Medical University, Rizhao 276826, Shandong Province, China.

Department of Neurosurgery, Donggang District People's Hospital, Rizhao 276826, Shandong Province, China.

出版信息

Neurol Neurochir Pol. 2018 Jan-Feb;52(1):25-28. doi: 10.1016/j.pjnns.2017.09.007. Epub 2017 Sep 22.

Abstract

OBJECTIVE

Pericallosal artery aneurysms are not common clinically. The microsurgery and endovascular therapy are surgically challenging operations. The objective of the study is to summarize their clinical symptoms and optimal treatment strategies of pericallosal artery aneurysms.

METHODS

Nine cases of pericallosal artery aneurysms detected by digital subtraction angiography (DSA) were reviewed. The clinical manifestation, brain imaging characteristics, and optimal treatment methods were summarized.

RESULTS

Patients with spontaneous aneurysm had good clinical outcomes after endovascular coiling or microsurgical clipping treatment. There were no any neurological function deficits in five patients. One patient suffered from permanent neurological function deficits. Patients with traumatic aneurysm pericallosal had relatively poor outcomes, including two patients showing disturbed consciousness and the paralysis of the lower limbs with slow recovery, and one patient was dead after the surgery.

CONCLUSION

Spontaneous subarachnoid hemorrhage and interhemispheric fissure hematoma suggest spontaneously pericallosal aneurysm, while traumatic corpus callosum hematoma as well the accompanying embryo of intraventricular hemorrhage suggest traumatic pericallosal aneurysm. Endovascular embolization is the primary surgical treatment for pericallosal aneurysm, while patients with pericallosal aneurysm are not suitable for surgical treatment. Microsurgical clipping treatment may be a choice. However, both of these treatment strategies have high risk.

摘要

目的

胼周动脉瘤在临床上并不常见。显微手术和血管内治疗是具有手术挑战性的操作。本研究的目的是总结胼周动脉瘤的临床症状和最佳治疗策略。

方法

回顾9例经数字减影血管造影(DSA)检测出的胼周动脉瘤病例。总结其临床表现、脑成像特征及最佳治疗方法。

结果

自发性动脉瘤患者经血管内栓塞或显微手术夹闭治疗后临床效果良好。5例患者无任何神经功能缺损。1例患者出现永久性神经功能缺损。创伤性胼周动脉瘤患者的预后相对较差,包括2例意识障碍和下肢瘫痪且恢复缓慢的患者,1例患者术后死亡。

结论

自发性蛛网膜下腔出血和大脑纵裂血肿提示自发性胼周动脉瘤,而创伤性胼胝体血肿以及伴随的脑室内出血雏形提示创伤性胼周动脉瘤。血管内栓塞是胼周动脉瘤的主要手术治疗方法,而胼周动脉瘤患者不适合手术治疗时,显微手术夹闭治疗可能是一种选择。然而,这两种治疗策略都具有高风险。

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