Diagnosis and mierosurgical intervenfion of small anterior communicating artery aneurysms
10.3760/cma.j.issn.1671-8925.2008.09.024
- VernacularTitle:小型前交通动脉瘤的诊断和显微手术治疗
- Author:
Xiao-Ping TANG
1
;
Jian QI
;
Guang-Fu HUANG
;
Wen-Guo TANG
;
Ding-Yong YU
;
Hua PENG
;
Tao ZHANG
;
Yuan-Chuan WANG
;
Ren-Guo LUO
;
Ling FENG
;
Zhang-Yang GOU
;
Jun-Wei DUAN
Author Information
1. 川北医学院附属医院
- Keywords:
Small anterior communicating artery aneurysm;
Subarachnoid hemorrhage;
Digital subtract angiography
- From:
Chinese Journal of Neuromedicine
2008;7(9):953-956
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnosis of small anterior communicating artery aneurysms and discuss the microsurgical techniques and the timing of surgical intervention.Methods Thirty-two cascs of small anterior communicating artery aneurysms were reviewed for the methods for lesion detection,imaging features of the lesions,microsurgical procedures and the patients'clinical outcome. Results CT displayed subarachnoid hemorrhage(SAH)in all the 32 cases.Magnetic resonance angiography(MRA) was performed in 13 cases and computed tomographic angiography (CTA)in 8 cases. All the 32 patients underwem a total of 35 examinations With digital subtract angiography(DSA).The time between operation and aneurysm rupture was less than 3 daysin 6 cases,4 to 14 days in 10 cases.10 to 14 days in 13 cases and over 30 days in 3 cases.Neck clipping of the aneurysm through the pterional approach was performed in all thc cases with tracheal intubation and general anesthesia,and hemorrhage due to ancurysm ruptures occurredin 5 cases during the operation.Death occurred in 1 case after the operation,and 5 patients developed hydrocephalus and received subsequent ventriculoperitoneal shunting.After the operation,22 patients showed good recovery,6 were capable of independent living, 2 needed assistance for walking and in daily activities, and 1 patient remained bed-ridden and needed nursing care.Follow-up of 27 patients for 3 to 12 months found no occurrence of hemorrhage or death.Conclusion DSA Can be the primary choice for diagnosis of small anterior communicating artery aneurysms.Earlyinterventions should be administered for grade I or Ⅱpatients,but for the other patients,the surgeries can be performed 2 or 3 weeks after the hemorrhage.Proficient microsurgical skills can be crucial for successful clipping of the aneurysms and for prevention and effective management of hemorrhage due to aneurysm rupture.
