Etiology of intracranial aneurysm
Cerebral aneurysms are more common at the bifurcation of basilar artery. According to the location of the disease, 4/5 is located in the first half of basilar artery ring, mostly internal carotid artery, posterior communicating artery and anterior communicating artery, and also found in the branches of middle cerebral artery or anterior cerebral artery. About 1/5 cases were found in the second half of the cerebral basilar artery ring, and most of them occurred in vertebrobasilar artery, posterior cerebral artery and its branches. Cystic aneurysms are common and vary in size, with a diameter less than 14mm, a large diameter of 15 ~ 24 mm, and a giant diameter of more than 25 mm. Trauma can also cause aneurysms, but it is rare.
Symptoms of intracranial aneurysm
80% of spontaneous subarachnoid hemorrhage is caused by ruptured aneurysm. When an aneurysm ruptures, there are usually precursor symptoms, such as headache, followed by bleeding symptoms, such as severe headache, irritability, nausea and vomiting, and then increased intracranial pressure. It may be accompanied by disturbance of consciousness and neurolocalization symptoms in the corresponding parts. Patients with large hematoma caused by aneurysm bleeding often deteriorate rapidly, leading to cerebral hernia crisis. According to statistics, after the first rupture of an aneurysm, the mortality rate is as high as 30 ~ 40%, half of them die within 48 hours after the onset, and 1/3 of the surviving cases can bleed again.
Examination of intracranial aneurysm
Cerebral angiography is the most accurate auxiliary diagnosis method, and whole cerebral angiography should be performed to find out whether there are multiple aneurysms. CT scan can sometimes show the focus of aneurysm. MRI examination can not only show aneurysm, but also see mural thrombus. Once the cerebral aneurysm is diagnosed, it must be treated surgically, so as to cure it radically and avoid the danger of massive bleeding.
Treatment of intracranial aneurysm
At present, craniotomy is often used to treat aneurysms directly. Use a special aneurysm clip to clamp the neck of the aneurysm to protect the patency of the parent artery. If the aneurysm base is too large or spindle-shaped and its collateral circulation is good, the parent artery can be ligated to isolate the aneurysm, or the aneurysm wall can be reinforced only with muscle sheets and bio-glue. Intra-arterial embolization can be used to treat the aneurysm, and the aneurysm can be automatically blocked by balloon or spring plug, so as to achieve the purpose of treatment.
treat cordially
1. Medical treatment: refer to the treatment of "spontaneous subarachnoid hemorrhage".
2. Surgical treatment: direct and indirect craniotomy.
3. Endovascular interventional therapy: The purpose is to introduce foreign bodies into the tumor cavity, thus promoting thrombosis and occlusion in the tumor.
Intracranial aneurysms are mostly congenital and come on late. Most of the first symptoms were spontaneous intracranial hemorrhage. If you have a sudden headache with unilateral oculomotor nerve paralysis, you should think of this disease. Drugs have no direct effect on aneurysms, and direct clipping of aneurysms through craniotomy is the best treatment. According to the situation, radial artery interventional therapy can also be used to block the aneurysm. To make a reasonable diagnosis and treatment of this disease, we need qualified hospitals and experienced experts, remember. For the initial bleeding, drug treatment may be better, but we should seize the opportunity and carry out fundamental treatment, so as not to miss the opportunity.
Curative effect evaluation
1. cure: the aneurysm is removed or disappeared, the symptoms disappear, and normal work is resumed.
2. Improvement: indirect surgery or aneurysm was not taken out, and the clinical symptoms were obviously improved, and some of them resumed work.
3. Untreated: The aneurysm has not been treated, and the symptoms have not improved.