Diagnosis and treatment of patients with middle cerebral artery aneurysms combined with intra-Sylvian hematomas
10.3760/cma.j.issn.1671-8925.2012.09.010
- VernacularTitle:大脑中动脉瘤伴侧裂区血肿的诊治策略
- Author:
Chao-Yan SONG
1
;
Zheng-Hui SUN
;
Bai-Nan XV
;
Chen WU
;
Zhe XUE
;
Hong-Wei MA
Author Information
1. 保定市第一医院
- Keywords:
Middle cerebral artery;
Aneurysm;
Intra-Sylvian hematoma;
Intraoperative monitoring;
Microsurgical management
- From:
Chinese Journal of Neuromedicine
2012;11(9):904-907
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the diagnosis and treatment experience of patients with middle cerebral artery aneurysms (MCAAs) associated with intra-Sylvian hematomas. Methods The clinical data of 21 patients with ruptured MCAAs associated with intra-Sylvian hematomas (haemorrhage ≥20mL), admitted to our hospital from November 2006 to May 2011, were analyzed retrospectively. Treatment experiences of MCAAs associated with intra-Sylvian hematomas with microsurgery were concluded. Results Among them,12 patients were performed clipping and 8 were performed resection and clipping. Bypass of superficial temporal artery to middle cerebral artery was performed before occlusion of the afferent artery in 1 patient.When the patients discharged from hospital,their Glasgow outcome scale (GOS) were 4-5 scores in 16 patients,3 scores in 3,2 scores in 1 and 1 score in 1; excellent outcomes were achieved in 15 patients, no marked changes in 4 patients, and post-operative complications were observed in 1 patient; 1 perioperative death occurred. Conclusion Ruptured MCAAs combined with intra-Sylvian hematomas should be differed from hypertension hemorrhage of basal ganglia areas; intraoperative Doppler sonography,introperative indocyanine green angiography and neurophysiological monitoring are helpful during the surgical treatment.
