摘要
目的研究成年出血性烟雾病患者的临床特点及DSA表现。方法对CT诊断为颅内出血。并经DSA确诊的68例烟雾病患者进行临床资料和DSA影像资料分析。结果68例患者中男23例，女45例，平均37．8岁。DSA表现：双侧前循环病变57例，合并后循环改变19例；单侧前循环病变9例，合并后循环改变6例；单纯后循环病变2例，单纯前循环病变41例。合并脑动脉瘤患者11例，其中7例进行了栓塞或开颅夹闭术。合并脑梗死患者13例。2次以上反复出血17例。脑室出血59例，脑实质出血7例，蛛网膜下腔出血2例。因脑出血量较大，需行开颅手术者6例。结论成人出血性烟雾病主要表现为脑室内出血，尤其中年女性多见。积极针对合并动脉瘤及症状的外科干预多能取得良好治疗效果，但难以防止再次出血。脑DSA是明确分析烟雾病病变特征及选择治疗方法的首要手段。
Objective To study the clinical characteristics and digital subtract angiography （DSA） manifestations of the hemorrhagic moyamoya disease in adults. Methods A retrospective study was conducted to analyze the clinical data and DSA imaging of 68 adult patients who had been diagnosed with intracerebral hemorrhage on CT and with moyamoya on DSA. Results They were 23 males and 45 females with an average of 37.8 years. Their DSA manifestations included bilateral lesions on the anterior cerebral circulation in 57 cases, 19 of whom had combined lesions on the posterior cerebral circulation; unilateral lesion on the anterior cerebral circulation in 9 cases, 6 of whom had combined lesions on the posterior cerebral circulation; simple lesions on the posterior cerebral circulation in 2 cases; simple lesions on the anterior cerebral circulation in 41 cases. Intracranial aneurysm was complicated in 11 cases, 7 of whom underwent aneurysm embolization or clipping of the aneurysm neck. Cerebral infarction was complicated in 13 cases. Repeated hemorrhage for twice or more occurred in 17 cases. Ventricle hemorrhage occurred in 59 cases, parenchymal hemorrhage in 7 cases, and subarachnoid hemorrhage in 2 cases. Craniotomy was performed in 6 cases of massive intracranial bleeding. Conclusions Adult patients with hemorrhagic moyarnoya disease, particular middle-aged women, usually have a major manifestation of intraventricular hemorrhage. Surgical interventions for combined aneurysms and symptoms can achieve a good therapeutic effect, but it is difficult to prevent re-hemorrhage. DSA is the primary method to determine specific characteristics ofmoyamoya lesions and consequently to choose a proper treatment.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2012年第2期189-191,共3页
Chinese Journal of Neuromedicine
