Early surgical treatment of ruptured middle cerebral artery aneurysms associated with intracerebral haematoma

CHEN Zhi; TANG Wei-hua; MIAO Hong-ping; WU Nan; ZHU Gang; FENG Hua

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Early surgical treatment of ruptured middle cerebral artery aneurysms associated with intracerebral haematoma

更新时间：2025-01-15

- Early surgical treatment of ruptured middle cerebral artery aneurysms associated with intracerebral haematoma
- Journal of Army Medical University Vol. 30, Issue 24, Pages: 2324-2326(2008)
- 作者机构：
  
  第三军医大学西南医院神经外科,全军神经系统疾病微创诊治专科中心
- 作者简介：
- 基金信息：
- DOI：
  CLC： R651.12;R739.41;R743.34
- Published：2008，
  
  Published Online：30 December 2008，
- 稿件说明：
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CHEN ZHI, TANG WEI-HUA, MIAO HONG-PING, et al. Early surgical treatment of ruptured middle cerebral artery aneurysms associated with intracerebral haematoma. [J]. Journal of army medical university, 2008, 30(24): 2324-2326.
DOI：

CHEN ZHI, TANG WEI-HUA, MIAO HONG-PING, et al. Early surgical treatment of ruptured middle cerebral artery aneurysms associated with intracerebral haematoma. [J]. Journal of army medical university, 2008, 30(24): 2324-2326. DOI：

摘要

目的探讨大脑中动脉动脉瘤破裂合并脑内血肿早期手术的疗效和经验。方法回顾性分析近5年9例大脑中动脉动脉瘤破裂合并脑内血肿患者，早期手术行动脉瘤夹闭及血肿清除术的治疗效果。7例患者术前经常规血管造影或（和）三维CT血管造影(three-dimensional CT angiography， 3D-CTA)检查证实，2例患者行CT检查直接手术。术中使用微血管多普勒超声辅助显露动脉瘤及检查动脉瘤夹闭前后载瘤动脉血流。结果 9例患者共10枚动脉瘤均成功夹闭，3个月后随访时GOS 评分恢复良好者4例，中度病残2例，重度病残2例，植物生存1例。结论大脑中动脉动脉瘤破裂合并脑内血肿患者病情危重，早期手术能有效改善预后，3D-CTA和术中多普勒超声等无创检查措施能为手术提供帮助。

Abstract

Objective To summarize the experience and effectiveness of early surgical treatment of middle cerebral artery (MCA) aneurysms associated with intracerebral haematoma. Methods Nine patients with ruptured MCA aneurysms associated with intracerebral haematoma

who underwent haematoma evacuation and aneurysmal clipping

were retrospectively reviewed. Preoperative conventional angiography or/and three-dimensional CT angiography (3D-CTA) was performed in seven patients. Another two patients underwent urgent surgery after CT scanning. Intraoperative Doppler sonography was used to assist exposure of aneurysms and parent vessels before and after aneurysm clipping. Results Ten aneurysms in nine patients were clipped. GOS at three months was good recovery in four cases

moderate disability in two

severe disability in two

and persistant vegetative state in one. Conclusion Acceptable outcome may be achieved in the patients with ruptured MCA aneurysms associated with intracerebral haematoma after early surgery. 3D-CTA and intraoperative Doppler sonography are helpful for surgical treatment.

关键词

颅内动脉瘤大脑中动脉脑内血肿显微外科手术

Keywords

intracranial aneurysmmiddle cerebral arteryintracerebral hematomamicrosurgery

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