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asbryobvrz · Wysłany: Nie 23:08, 13 Mar 2011

Parent artery embolization for intracranial aneurysms spasm in 18 cases under

Oxygenease a 1genetherapyforpreventionofvasospasminrats [J]. JNeurosurg, 2002; 6 (6) :1098-1102. Editor Wang Xiaozhong ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ◆ ● ◆ ● ● ● ● ● ● ● ● ● ● ● ● ● * exchange of experience Article ID :1000 -2790 (2005) 02-0132-01 0 cases death. Parent artery embolization for intracranial aneurysms spasm in 18 cases under Section Michael Ma, Gao Guodong, FORCES, composers straight, Deng Jianping, Zhao Jipei (Tang Du Hospital, Fourth Military Medical University, Neurosurgery, Xi'an 710038, China) Key words parent artery spasm; embolism; aneurysm in No.】【R816.1 Document code】【clinical data B1 Tang asked the Department of Neurosurgery in the 2004-02/2004-05 electrolytic coil embolization of intracranial aneurysms in patients with a total of 46 cases, of which there parent artery spasm 18 (6 males, 12 females), aged 17 to 65 years, mean 42 years old, are spontaneous subarachnoid hemorrhage as the first symptom, clinical manifestations were headache, vomiting, neck strong. 8 cases were associated with disturbance of consciousness; limb dysfunction in 3 cases; 1 case of posterior communicating artery aneurysm associated with oculomotor palsy. Preoperative Hess. Hunt grade I level l cases, Ⅱ 9 cases, Ⅲ grade 7 cases, Ⅳ 1 case. All cases were diagnosed there DSA angiography of intracranial aneurysms and parent artery spasm. L1 anterior communicating artery aneurysm in which case,[link widoczny dla zalogowanych], 4 cases of posterior communicating artery aneurysm, middle cerebral artery bifurcation aneurysm in 2 cases, 1 case of ophthalmic artery aneurysm. All cases were electrolytic coils. Routine lumbar puncture and cerebrospinal fluid after bloody discharge, application of calcium antagonists, intravenous papaverine 2wk,[link widoczny dla zalogowanych], while the high cerebral perfusion pressure, high volume,[link widoczny dla zalogowanych], low blood viscosity and other comprehensive treatment. Endovascular treatment of discharge functional assessment: excellent (no neurological deficit); good (mild neurological dysfunction); poor (moderate or severe neurological disorders); vegetative state and death. This group of patients: excellent in 13 cases,[link widoczny dla zalogowanych], good in 4 cases, poor in 1 case, persistent vegetative state and death Received Date :2004 -06-18; Revised :2004-08.28 Author: Michael Ma Department (1970.), M (Han), Fufeng County of Shaanxi Province. Attending Te1. (0917) 5213783. Present unit: Shaanxi Provincial People's Hospital, Neurosurgery Fufeng true. 2.1 2 discussions under the parent artery embolization spasticity time after intracranial aneurysm is a life-threatening bleeding complications, and may occur at any time,[link widoczny dla zalogowanych], for the first time after bleeding easily re-bleeding within 2wk, and by patients with psychological, environmental, climate, age and other factors. So long as the patients general permit are as early as possible embolization. 2.2 Spontaneous embolization of hemorrhage under the main web aneurysms rupture, about 1/5-2/3 of the aneurysm hemorrhage associated with cerebral artery spasm, bleeding on the brain tissue itself, the damage caused by vasospasm Cerebral ischemia is an important factor affecting the prognosis, thus avoiding the increased intraoperative cerebral vasospasm and vasospasm after early discharge is to improve the prognosis. Gentle action to reduce micro-surgery and micro-guide wire catheter spasm state of parent artery stimulation, try shortening process; attention to the changes of intraoperative DSA, especially the blood supply to areas of compensatory vascular spasm vascular; after the release of bloody lumbar puncture cerebrospinal fluid, blood components can reduce its degradation products on vascular stimulation; early application of calcium antagonists, expansion of cerebral blood vessels, improve cerebral circulation, improve neuronal ischemic tolerance; early application of papaverine 2wk, there is dilatation of the artery spasm ; while high cerebral perfusion pressure, high volume, low blood viscosity and other comprehensive treatment. In short, under the parent artery embolization spastic cerebral aneurysms prone to complications, but early on the correct assessment of compensatory blood vessels before surgery to prevent, after close observation and timely treatment can often minimize complications, to obtain more good therapeutic effect. 【
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