[1]杨洪宽 陈 豪 陈如东 厉 华 于加省 雷 霆.大脑前动脉A1段动脉瘤的临床特点及治疗(附8例分析)[J].中国临床神经外科杂志,2017,(09):613-616.[doi:10.13798/j.issn.1009-153X.2017.09.002]
 YANG Hong-kuan,CHEN Hao,CHEN Ru-dong,et al.Clinical characteristics and treatment of aneurysms arising from anterior cerebral artery A1 segment[J].,2017,(09):613-616.[doi:10.13798/j.issn.1009-153X.2017.09.002]
点击复制

大脑前动脉A1段动脉瘤的临床特点及治疗(附8例分析)()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年09期
页码:
613-616
栏目:
论著
出版日期:
2017-09-25

文章信息/Info

Title:
Clinical characteristics and treatment of aneurysms arising from anterior cerebral artery A1 segment
文章编号:
1009-153X(2017)09-0613-04
作者:
杨洪宽 陈 豪 陈如东 厉 华 于加省 雷 霆
430030 武汉,华中科技大学同济医学院附属同济医院神经外科
Author(s):
YANG Hong-kuan CHEN Hao CHEN Ru-dong LI Hua YU Jia-sheng LEI Ting
Department of Neurosurgery, Tongji Hospital, Tongji Medical School, Huazhong University of Sciences and Technology, Wuhan 430030, China
关键词:
颅内动脉瘤大脑前动脉A1段蛛网膜下腔出血显微手术血管内栓塞
Keywords:
Intracranial aneurysm Anterior cerebral artery A1 segmnet Subarachnoid hemorrhage Clipping Embolization
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2017.09.002
文献标志码:
A
摘要:
目的 探讨大脑前动脉A1段动脉瘤的临床特征以及治疗方式。方法 回顾性分析2010年1月至 2014年3月收治的8例大脑前动脉A1段动脉瘤的临床资料。结果 蛛网膜下腔出血6例,未破裂2例;栓塞治疗4例,夹闭4例。术后随访12~36个月;6例可正常工作生活,2例生活基本能够自理;改良Rankin量表评分2分2例,1分2例,0分4例;8例DSA或CTA复查均未见复发。结论 大脑前动脉A1段动脉瘤破裂可主要表现为蛛网膜下腔出血,血管内栓塞治疗及显微夹闭术均是可行并有效的治疗方法。
Abstract:
Objective To explore the clinical characteristics and treatment of intracranial aneurysm arising from anterior cerebral artery (ACA) A1 segments. Methods The clinical data of 8 patients with ACA A1 segment aneurysms confirmed by cerebral DSA were analyzed retrospectively, including clinical and imaging characteristics, therapeutic method and so on. Results Of 8 patients with A1 segment aneurysms, 6 had subarachnoid hemorrhage and 2 not. Four patients were treated by endovascular embolization and 4 by surgery. All the patients had good curative effects. Conclusions The mainly clinical manifestation of the intracranial aneurysm arising from ACA A1 segment is SAH. DSA is the golden standard of diagnosis of A1 segment intracranial aneurysms, which can be treated by endovascular embolization or microsurgery. The curative effects of endovascular embolization and microsurgery on A1 segment aneurysms are good.

参考文献/References:

[1] Rasing I, Ruigrok YM, Greebe P, et al. Long-term risk of aneurysmal subarachnoid hemorrhage after a negative aneurysm screen [J]. Neurology, 2015, 84(9): 912-917.
[2] 陈 刚,李 俊,徐国政,等. 大脑前动脉-胼周动脉动脉 瘤的临床特点及其治疗(附23例报告)[J]. 中国临床神经 外科杂志,2011,16:714-716.
[3] Gewirtz RJ, Awad IA. Giant aneurysms of the proximal ante- rior cerebral artery: report of three cases [J]. Neurosurgery, 1993, 33(1): 120-125.
[4] Wanibuchi M, Kurokawa Y, Ishiguro M, et al. Characteris- tics of aneurysms arising from the horizontal portion of the anterior cerebral artery [J]. Surg Neurol, 2001, 55: 148-155.
[5] Koh JS, Kim EJ, Lee SH. Ruptured aneurysm arising from the distal end of a proximal a(1) fenestration: case report and review of the literature [J]. J Korean Neurosurg Soc, 2009, 45(1): 43-45.
[6] Dashti R, Hernesniemi J, Lehto H, et al. Microneurosurgical management of proximal anterior cerebral artery aneurysms [J]. Surg Neurol, 2007, 68(4): 366-377.
[7] Minami N, Kimura T, Ichikawa Y, et al. Emerging sylvian- subpial hematoma after the repair of the ruptured anterior cerebral artery aneurysm with interhemispheric approach: case report [J]. Neurol Med Chir (Tokyo), 2014, 54(3): 227- 230.
[8] Hloba MV. Prognostication of ischemic complications of cerebral vasospasm in surgical treatment of intracranial aneurysm in acute period of its rupture [J]. Klin Khir, 2014, (9): 44-47.
[9] Niikawa S, Yasokawa Y, Ito T. Development of early cerebral swelling in surgically treated ruptured aneurysm of acute stage, its significance, and management [J]. J Stroke Cere- brovasc Dis, 2005, 14(2): 58-66.
[10] Cohen-Gadol AA. Tackling technical challenges for micro- surgical clip ligation of complex aneurysms during the endovascular era: a personal perspective [J]. Neurosurgery, 2014, 61(Suppl 1): 43-53.
[11] Luo YC, Shen CS, Mao JL, et al. Ultra-early versus delayed coil treatment for ruptured poor-grade aneurysm [J]. Neuro- radiology, 2015, 57(2): 205-210.
[12] Hayashi K, Horie N, Nagata I. A case of unilateral moyamo- ya disease suffered from intracerebral hemorrhage due to the rupture of cerebral aneurysm, which appeared seven years later [J]. Surg Neurol Int, 2013, 4: 17.
[13] Chalouhi N, Tjoumakaris S, Thakkar V, et al. Endovascular management of cerebral vasospasm following aneurysm rupture: outcomes and predictors in 116 patients [J]. Clin Neurol Neurosu, 2014, 118: 26-31.
[14] Wang K, Zuo G, Zheng L, et al. Effects of tirofiban on platelet activation and endothelial function in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention [J]. Cell Biochem Bio- phys, 2015, 71(1): 135-142.

相似文献/References:

[1]曾 春 张施远 蒋永明.复合手术与常规夹闭术治疗颈内动脉后交通动脉破裂动脉瘤的疗效对比研究[J].中国临床神经外科杂志,2016,(05):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
 ZENG Chun,ZHANG Shi-yuan,JIANG Yong-ming.Analysis of the effects of hybrid surgery on posterior communicating artery aneurysms: a comparison with conventional craniotomy[J].,2016,(09):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
[2]周有东 敖祥生 刘汉东 王志勇 朱耀祖 周达全.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,(05):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
 ZHOU You-dong,AO Xiang-sheng,LIU Han-dong,et al.A mata-analysis of curative effects of stent-assisted coiling and simple coiling on intracranial aneurysms and their safety[J].,2016,(09):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
[3]赵 平 王雄伟 汪 雷 马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
 ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(09):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[4]李朝晖 王玉贵 张孟超 综述 赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[5]刘福德 邓剑平 张 涛 陈 虎 李 帅 王俭博 曲友直 赵振伟.椎-基底动脉夹层动脉瘤的血管内治疗(附48例分析)[J].中国临床神经外科杂志,2016,(06):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
 LIU Fu-de,DENG Jian-ping,ZHANG Tao,et al.Endovascular treatment of vertebrobasilar artery dissecting aneurysms (report of 48 cases)[J].,2016,(09):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
[6]吴有志 罗良生 张 健 陈 骅 吴 鸣 刘 振 史 岩.前循环破裂动脉瘤伴脑内血肿的 早期显微手术治疗[J].中国临床神经外科杂志,2016,(06):376.[doi:10.13798/j.issn.1009-153X.2016.06.020]
[7]潘 力 刘 鹏 秦 杰 杨 柳 安学峰 吴 虓 杨 铭 徐国政 马廉亭.Y型支架辅助技术在颅内动脉分叉部宽颈动脉瘤治疗中的应用[J].中国临床神经外科杂志,2016,(07):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
 PAN Li,LIU Peng,QIN Jie,et al.Application of Y -configuration stent technique to treatment of intracranial wide-neck bifurcation aneurysms[J].,2016,(09):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
[8]周 量 刘 丛 张昌伟.早期栓塞术治疗动脉瘤性蛛网膜下腔出血的疗效[J].中国临床神经外科杂志,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
 ZHOU Liang,LIU Cong,ZHANG Chang-wei..Curative effect of early endovascular embolization on patients with ruptured intracranial aneurysms[J].,2016,(09):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
[9]张 莹 荆林凯 张倩倩 刘 健 张义森 王 坤 穆士卿 杨新健.颈内动脉后交通动脉小动脉瘤破裂危险因素分析[J].中国临床神经外科杂志,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
 ZHANG Ying,JING Lin-kai,ZHANG Qian-qian,et al.Analysis of risk factors related to rupture of small (diameter ≤5 mm) posterior communicating artery aneurysms[J].,2016,(09):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
[10]朱作磊 综述 罗良生 审校.动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J].中国临床神经外科杂志,2016,(03):183.[doi:10.13798/j.issn.1009-153X.2016.03.020]
[11]吴德刚 李真保 赵心同 袁金龙 秦飞云 盛 斌 张兵兵 方兴根.大脑前动脉A1段动脉瘤的血管内治疗[J].中国临床神经外科杂志,2017,(10):680.[doi:10.13792017.09/j.issn.1009-153X.2017.10.003]
 WU De-gang,LI Zhen-bao,ZHAO Xin-tong,et al.Endovascular treatment of aneurysms of proximal segments (A1) of anterior cerebral arteries[J].,2017,(09):680.[doi:10.13792017.09/j.issn.1009-153X.2017.10.003]

备注/Memo

备注/Memo:
基金项目:武汉市科技局科技攻关计划(200960323130);湖北省自然科学基金(2014CFB151) 作者单位:430030 武汉,华中科技大学同济医学院附属同济医院神经外科(杨洪宽、陈 豪、陈如东、厉 华、于加省、雷 霆) 通讯作者:于加省,E-mail:yujiasheng2000@sina.com
更新日期/Last Update: 1900-01-01