Traumatic intracranial aneurysms.
Traumatic intracranial aneurysms.
复制标题
外伤性颅内动脉瘤。
DOI：
10.3171/foc.2000.8.1.1829
复制
发表时间：
2000
影响因子：
4.1
通讯作者：
J. Harpring
中科院分区：
文献类型：
--
作者：
P. Larson;A. Reisner;D. Morassutti;Bassam Abdulhadi;J. Harpring
外伤性颅内动脉瘤很少见，发生在脑动脉瘤患者中的比例不到 1%。它们可能发生在钝性或穿透性头部创伤后，并且在儿科人群中更常见。创伤性动脉瘤在组织学上可分为真性动脉瘤、假性动脉瘤或混合性动脉瘤，其中假性动脉瘤最为常见。这些动脉瘤可以多种方式出现，但通常与迟发性颅内出血的急性发作有关，从最初的创伤到动脉瘤出血的平均时间约为 21 天。患有这些动脉瘤的患者的死亡率可能高达 50%。基于动脉造影的及时诊断和积极的手术治疗比保守治疗有更好的结果。作者根据其解剖位置描述了创伤性动脉瘤的分类方案，并得出结论：1）闭合性头部损伤后出现急性神经功能恶化的患者必须考虑创伤后动脉瘤； 2) 它们可能发生在轻度闭合性头部损伤后； 3）儿童比成人更常见； 4) 手术夹闭和/或血管内闭塞是最终的治疗方法。
Traumatic intracranial aneurysms are rare, occurring in fewer than 1% of patients with cerebral aneurysms. They can occur following blunt or penetrating head trauma and are more common in the pediatric population. Traumatic aneurysms can be categorized histologically as true, false, or mixed, with false aneurysms being the most common. These aneurysms can present in a variety of ways, but are typically associated with an acute episode of delayed intracranial hemorrhage with an average time from initial trauma to aneurysm hemorrhage of approximately 21 days. The mortality rate for patients harboring these aneurysms may be as high as 50%. Prompt diagnosis based on arteriography and aggressive surgical management are associated with better outcome than conservative treatment. The authors describe a classification scheme for traumatic aneurysms based on their anatomical location and conclude that 1) posttraumatic aneurysm must be considered in patients with acute neurological deterioration following closed head injury; 2) they can occur following mild closed head injury; 3) they occur more commonly in children than in adults; and 4) surgical clipping and/or endovascular occlusion is the definitive treatment.