脑前远端动脉瘤的发现与治疗

Yacine FELISSI
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摘要

胼胝体周围动脉瘤可影响前交通动脉远端的大脑前动脉的任何一段。它们约占所有颅内动脉瘤的9%,主要表现为不同形式的出血性中风。本回顾性研究回顾了所有脑动脉瘤病例中所有接受DACA动脉瘤夹持术的患者。本组纳入10例患者,对多项参数进行评估。60%的患者为女性,年龄44 ~ 78岁。80%的候选人抱怨头痛,50%的人出现癫痫发作。60%的患者在首次就诊时出现IPH,而其中一半的患者发现SAH。WFNS评分良好,约80%的患者为i级。大部分动脉瘤(80%)位于胼胝体周围-胼胝体边缘交界处。我们有2例(20%)在其他部位有额外的动脉瘤。所有患者均接受显微手术夹持。他们中的大多数都有良好的短期和长期随访。我们有一个死于几个系统性并发症。DACA动脉瘤以小尺寸出现,并伴有带状血肿或SAH,尤其是在半球间池。这可能会影响认知功能,并被认为是患者生活质量的决定性因素。手术夹是一种有效而持久的治疗方法
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Revelation and Management of Distal Anterior Cerebral Artery Aneurysms
Pericallosal aneurysms can affect any segment of the anterior cerebral artery distal to the anterior communicating artery. They represent relatively 9% of all intracranial aneurysms and are mainly revealed by a hemorrhagic stroke in different forms. This retrospective study reviewed all patients that received clipping for DACA aneurysms among all cases of brain aneurysms. 10 patients were included in this group and several parameters were evaluated. 60% of patients were female and their ages ranged from 44 to 78 years. 80% of candidates complained of headaches and 50% presented seizures clipping. 60% of patients presented an IPH at their first presentation while SAH was found in half of them. A good WFNS score was noticed and almost of patients (80 %) were graded I. Most of aneurysms (80%) were located at the pericallosal – callosomarginal junction. We had two cases (20%) with additional aneurysms in other localizations. All of them received microsurgical clipping. most of them had good short and long -term follow-ups. We had one death after several systemic complications. DACA aneurysms are revealed at a small size with the onset of cingular hematoma or SAH, especially in the interhemispheric cistern. This could affect the cognitive functions and is considered a determining factor in the patient’s quality of life. The surgical clipping is an effective and durable option for their management
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