Management of ruptured anterior communicating artery aneurysms presenting with sudden paraplegia
10.11855/j.issn.0577-7402.2016.09.14
- Author:
Jiu-Hong MA
1
Author Information
1. Department of Neurosurgery, Shanxi Provincial People’s Hospital
- Publication Type:Journal Article
- Keywords:
Embolization;
Intracranial;
Intracranial aneurysm;
Paraplegia;
Therapeutic;
Vasospasm
- From:
Medical Journal of Chinese People's Liberation Army
2016;41(9):771-772
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the causes of ruptured anterior communicating artery aneurysms presenting with paraplegia, and summarize the key points of diagnosis and treatment methods. Methods A total of 260 patients with ruptured anterior communicating artery aneurysms were received medical treatment in the Department of Neurosurgery, Shanxi Provincial People's Hospital from Jan. 2012 to Mar. 2015. Of which 6 patients were clinically presented with paraplegia, their clinical data including CT/MR/DSA were retrospectively analyzed, and based on the analysis, aneurysm embolization and anti-vasospasm treatment were performed. Results Besides headache and discomfort in the neck, 5 of the 6 patients were with double lower limbs paraplegia, and the another one presented quadriplegia. By symptomatic treatment of aneurysm embolization and anti vasospasm, the myodynamia of the paraplegic limbs recovered from 0-I to IV-V grade, and 2 of the 6 patients spent a shorter recovery time (about 2 weeks), the other 4 recovered in 3 months. The limbs myodynamia of the 6 patients recovered completely in half- and one year follow up. Conclusions The mechanism of ruptured anterior communicating artery aneurysms presenting with paraplegia may be the insufficient blood supply to the primary motor area and supplementary motor area (SMA) of brain cortex caused by aneurysms rupture. Aneurysm embolization should be performed in clinical treatment, supplemented with anti vasospasm and symptomatic treatment of improving neurological function.
