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颅内动脉瘤诊治中的诊断和治疗困境。

DIAGNOSTIC AND THERAPEUTIC DILEMMAS IN THE MANAGEMENT OF INTRACRANIAL ANEURYSMS.

机构信息

1Department of Neurology, Zagreb University Hospital Center, Zagreb, Croatia; 2Department of Functional Genomics, Center for Translational and Clinical Research, University of Zagreb School of Medicine, Zagreb University Hospital Center, Zagreb, Croatia; 3Department of Radiology, Zagreb University Hospital Center, Zagreb, Croatia; 4Ministry of Health, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2021 Dec;60(4):758-764. doi: 10.20471/acc.2021.60.04.24.

Abstract

Intracranial aneurysms have a prevalence of about 2% of the population. They are a common incidental finding of noninvasive neuroimaging methods, raising the question of the necessity of treatment of patients with an asymptomatic intracranial aneurysm. For long, the only treatment option was surgical clipping of aneurysm neck. In the last 25 years, endovascular techniques have been developed as an alternative solution for patients who are not eligible for neurosurgical procedures. Research has shown better results of embolization procedures with lower rates of complications, but a higher rate of recanalization is still a major drawback of endovascular coiling. There are no strict protocols and the treatment of choice for intracranial aneurysms should be agreed upon by both the physician and the patient. This review aims to provide an insight into the management of intracerebral aneurysms with emphasis on the decision making problems faced by clinicians.

摘要

颅内动脉瘤的人群患病率约为 2%。它们是无创性神经影像学方法的常见偶然发现,这引发了一个问题,即是否需要对无症状颅内动脉瘤患者进行治疗。长期以来,治疗颅内动脉瘤的唯一选择是手术夹闭瘤颈。在过去的 25 年中,血管内技术已发展成为不适合神经外科手术的患者的另一种解决方案。研究表明,栓塞术的结果更好,并发症发生率更低,但再通率仍然是血管内线圈的主要缺点。目前没有严格的治疗方案,颅内动脉瘤的治疗选择应由医生和患者共同商定。本综述旨在深入了解颅内动脉瘤的治疗方法,并重点讨论临床医生所面临的决策问题。

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