颅内动脉瘤的诊断及治疗讲课用.ppt

颅内动脉瘤的诊断及治疗
Intracranial aneurysm diagnosis and therapy
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Epidemiology
Morbility : 6～ thousands
area ：
Lowest：India、the Middle East 、China 1 ～2/100 thousands
Highest：Finland、Japan、Scotland ～ thousands
F:M ～:1。Common age:40-60 years ， about2/3。
Linn FH, Rinkel GJ, Algra A, van Gijn J. Incidence of subarachnoid hemorrhage: role of region, year, and rate of computed tomography: a meta-analysis. Stroke. 1996 Apr;27(4):625-9.
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Aneurysm etiology
1、Congenital 80%～90%
2、Arteriosclerosis 10%～18%
3、Infective %～%
4、Traumatic %
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Risk factors
1、Age
2、heredity
3、blood flow dynamic
4、Defects in the arterial wall of the middle
5、Aneurysms coexist with other congenital anomalies
6、Hypertension
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Aneurysm classification
size：：＜；：-；：-；：≥
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Aneurysm classificationshape：1 、capsular 2、intervallum 3、Fusiform
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anterior of Willis arterial circle > 80%
internal carotid artery ICA 30%
anterior cerebral artery ACA 30%
middle cerebral artery MCA 20%
vertebral artery
and basilar artery VA&BA 5%
others 15%
Aneurysm classificationcommon position:
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Aneurysm classificationposition:
Rhoton, Albert L. Neurosurgery. 51(4), October 2002
0
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Locations of aneurysm rupture
Top 64%
Middle 10%
Neck 2%
unclear 24%
Top-rupture
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Clinical presentation of intracranial aneurysmnon-rupture1、No clinical symptoms, physical examination when the accidental discovery2、Intracranial pressure symptoms
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