CAJ | 학술논문

目的探讨创伤性颅内动脉瘤的早期诊断和治疗以及对改善预后的意义.方法前瞻性研究高度怀疑为创伤性颅内动脉瘤的42例外伤患者,早期行DSA检查,诊断明确的给予及时治疗.结果病情平稳后立即行DSA检查,检查在入院后1-7d,共发现8例创伤性颅内动脉瘤患者,8个动脉瘤,6例位于大脑前动脉分支,2例位于颈内动脉段.3例在破裂之前、5例在二次破裂之前行手术或介入治疗,其中3例行开颅手术治疗,5例行介入治疗.随访12个月,无再出血病例,无手术相关死亡病例,6例行DSA复查未见复发,2例因经济原因未行复查.术后肢体偏瘫加重1例,3个月时肢体肌力恢复正常.结论对于高度怀疑为创伤性颅内动脉瘤的患者,应早期行DSA检查,手术或介入治疗是治疗创伤性动脉瘤有效方法.
목적 탐토창상성로내동맥류적조기진단화치료이급대개선예후적의의.방법 전첨성연구고도부의위창상성로내동맥류적42예외상환자,조기행DSA검사,진단명학적급여급시치료.결과 병정평은후립즉행DSA검사,검사재입원후1-7d,공발현8례창상성로내동맥류환자,8개동맥류,6례위우대뇌전동맥분지,2례위우경내동맥단.3례재파렬지전、5례재이차파렬지전행수술혹개입치료,기중3례행개로수술치료,5례행개입치료.수방12개월,무재출혈병례,무수술상관사망병례,6례행DSA복사미견복발,2례인경제원인미행복사.술후지체편탄가중1례,3개월시지체기력회복정상.결론 대우고도부의위창상성로내동맥류적환자,응조기행DSA검사,수술혹개입치료시치료창상성동맥류유효방법.
Objective To study the early angiographic diagnosis and treatment of traumatic intracranial aneurysms(TICA).Methods From Jan 2005 to Jun 2010,the diagnostic angiography was performed on 42 patients of craniocerebral trauma doubted to be TICA.And then the TICAs were treated by endovascular or surgical techniques.Results 8 TICAs were diagnosed.Six aneurysms were located on branches of the anterior cerebral artery,and two internal carotid artery.3 TICAs were treated before rupture and 5 before second rupture.3 TICA were treated by surgery and 5 endovascular techniques.There was no recanalization was detected in 6 patients. Two patients refused angiographic follow - up. There was no patient presented with delayed bleeding (mean follow -up duration:12 months).There was significant postoperative worsening in the contralateral extremities in one patient which improved within 3 months.There was no procedure - related complication or mortality. Conclusions Early angiographic diagnosis could provid an effective approach for TICA detection.Early endovascular or surgical therapy may allow early aneurysm exclusion with excellent results.