The Analysis of the Clinical Treatment of Rupture Hemorrhage in Intracranial Aneurysm

LI Fang; LAI Xian-liang; MAO Guo-hua

doi:10.3969/j.issn.1674-6805.2013.31.004

Abstract：Objective:To analyze the effects of craniotomy clipping and endovascular embolization in the treatment of intracranial aneurysms.Method:The clinical data of 495 cases who were treated in our hospital from Jan 2009 to Dec 2011 were analyzed retrospectively,includings 223 cases the group of craniotomy microsurgical clipping(CMC),272 cases in the group of Endovascular embolization(EE).Hunt and Hess grade:Craniotomy microsurgical clipping(I-Ⅲ:165 cases,Ⅳ-Ⅴ:58 cases),Endovascular embolization(Ⅰ-Ⅲ:198 cases,Ⅳ-Ⅴ:74 cases).There were no significant differences in the Hunt-Hess grade between two groups(P>0.05).Some indicators of the intracranial aneurysms were observed,includes the embolization degree,the recovery evaluation according to the GOS score after postoperative 3 months and 1 year,the complications,and the hospitalization time.Result:The rate of aneurysmal obliteration in CMC was 95.96%(214 cases),which in the EE was 76.47%(208 cases).Favorable prognosis(GOS 4-5):There were 198 cases in CMC(88.79%),there were 231 cases in EE(84.93%). Complications:The rate of postoperative cerebral infarction in CMC was 10.76%(24 cases),which in EE was 12.87%(35 cases).The rate of postoperative hydrocephalus in CMC was 9.42%(21 cases),which in EE was 13.60%(37 cases).The average hospitalization time in CMC was (15.0±7.5)d,which in EE was (8.0±4.2)d.Conclusion:Both craniotomy clipping and endovascular embolization have significant efficacy in the treatment of intracranial aneurysms,and two ways have their own advantages.