摘要目的 探讨"低位型"后交通动脉瘤的诊断及显微手术治疗方法.方法 回顾性分析16例经术中证实的"低位型"后交通动脉瘤患者的影像及临床资料.采用硬膜外磨除前床突的方法5例,单纯切开前床岩皱裂8例,切开皱裂结合硬膜内磨除前床突者3例.结果 所有患者均顺利夹闭瘤颈.其中术中破裂出血2例;术后出现短暂性肢体活动障碍2例;视力下降1例,出院时恢复良好.无死亡病例.结论 术前仔细阅读患者的影像学资料,可帮助了解瘤颈与前床突骨质之间的关系.辅以合理的显微手术技巧,有助于载瘤动脉临时阻断及近端瘤颈的显露及瘤夹的安置,提高手术疗效.

abstractsObjective To explore the diagnosis and microsurgical treatment of "low-lying" internal carotid-posterior communicating aneurysms.Methods The clinical data of 16 cases confirmed as "low -lying" internal carotid -posterior communicating aneurysms in our hospital since 2006 were retrospectively analyzed.Epidural anterior clinoidectomy was used in 5 cases, simple incision of anterior petroclinoid fold in 8 cases and combination of intradual anterior clinoidectomy in 3 cases.Results All the patients got aneurysm neck clipping totally.There were intra -operative hemorrhage in 2 cases, transient physical activity obstacles in 2 patients and decline eyesight in 1 case postoperative.All patients got good recovery at discharge.There was no death.Conclusion We should carefully read the image data to understand the relationship between aneurysm neck and anterior clinoid preoperatively.The application of incision of anterior petroclinoid fold and/or anterior clinoidectomy are helpful for temporary occlusion of parent artery and increasing the visualization of the proximal neck of aneurysms, which could achieve good results.