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首页> 外文期刊>Neurosurgery >Aneurysms of the distal anterior cerebral artery: results in 59 consecutively managed patients.
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Aneurysms of the distal anterior cerebral artery: results in 59 consecutively managed patients.

机译：远端前脑动脉的动脉瘤：连续治疗59例患者的结果。

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OBJECTIVE: The aim of this study was to present the clinical and radiological characteristics, surgical management, and outcome in a large series of patients with aneurysms of the distal anterior cerebral artery (DACA) managed in the microsurgical era. METHODS: The records of 1109 patients with anterior circulation aneurysms managed at the authors' institution between 1970 and 1998 were reviewed. RESULTS: Fifty-nine patients (5.3%) were identified with 67 DACA aneurysms. Seventy-three percent of the patients were women. The mean age of all patients was 47 years. Multiple aneurysms were identified in 51% of all patients, most commonly on the middle cerebral artery. Thirty-six patients had ruptured DACA aneurysms and 23 had unruptured aneurysms. In those with ruptured aneurysms, the admission grade was Grade I in 10 patients (27.8%), Grade II in three patients (8.3%), Grade III in 10 patients (27.8%), Grade IV in seven patients (19.4%), and Grade V in six patients (16.7%). Frontal lobe hematomas occurredin 28% of the patients with ruptured aneurysms and carried a poor prognosis. In those with unruptured aneurysms, 11 were incidental and 12 were identified after a subarachnoid hemorrhage from another aneurysm. The mean diameter was 10 mm in ruptured aneurysms and 5.8 mm in unruptured aneurysms. Fifty-eight patients underwent surgery and one patient was treated with endovascular coiling. Six patients, all with ruptured aneurysms, died. Seventy percent of survivors with ruptured aneurysms had a favorable outcome. CONCLUSION: DACA aneurysms possess a number of characteristics that distinguish them from the more common intracranial aneurysms. With modern neurosurgical and endovascular techniques, an acceptable operative morbidity and mortality can be achieved.
机译：目的：本研究的目的是介绍在显微外科时代处理的一系列患有远端前脑动脉瘤（DACA）的患者的临床和放射学特征，手术治疗和结局。方法：回顾性分析了1970年至1998年在作者机构管理的1109例前循环动脉瘤患者的病历。结果：59例患者（5.3％）被确认患有67例DACA动脉瘤。百分之七十三的患者是女性。所有患者的平均年龄为47岁。在所有患者中有51％发现了多发性动脉瘤，最常见于大脑中动脉。 36例DACA动脉瘤破裂，23例未破裂动脉瘤。在动脉瘤破裂的患者中，入院等级为10级患者为I级（27.8％），三级患者为II级（8.3％），10级患者为III级（27.8％），七级患者为IV级（79.4％），六名患者（16.7％）为V级。额叶血肿发生在28％的动脉瘤破裂患者中，预后较差。在那些动脉瘤未破裂的患者中，由于另一动脉瘤蛛网膜下腔出血后偶发了11例，鉴定出12例。破裂动脉瘤的平均直径为10毫米，未破裂动脉瘤的平均直径为5.8毫米。 58例患者接受了手术，其中1例接受了血管内盘绕治疗。六个动脉瘤破裂的患者死亡。动脉瘤破裂的幸存者中有70％的结果良好。结论：DACA动脉瘤具有许多特征，使其与较常见的颅内动脉瘤区别开来。利用现代的神经外科和血管内技术，可以实现可接受的手术发病率和死亡率。

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