ABSTRACT
Objective To investigate the therapies choice of paraclinoid carotid micro-aneurysm.Methods Eighteen patients suffered from paraclinoid carotid microaneurysm,definitely diagnosed by clinical measures and images,were chosen in our study; their clinical data were retrospective analyzed; among them,4 cases suffered from carotid ophthalmic aneurysms,including 3 accepted endovascular treatment and 1 microsurgical clipping; 10 cases suffered from internal carotid artery posterior communicating artery aneurysm,and 3 of them got endovascular treatment and 1 microsurgical clipping; 3 cases had anterior choroidal artery aneurysm of internal carotid artery,including 1 received endovascular treatment and 2 microsurgical clipping; and one was diagnosed as having internal carotid artery bifurcation aneurysms and clipping was performed.Results One patient suffered from carotid ophthalmic aneurysm died from re-rupture after endovascular treatment.One patient suffered from internal carotid artery posterior communicating artery aneurysm died from re-rupture after stent assisted coil embolization.One suffered from internal carotid artery posterior communicating artery aneurysm got good recovery (a spring ring escaped when taking coil embolization of aneurysm,and microsurgical clipping was then performed).Others got well.Conclusion Micro-aneurysms located in supraclinoid intemal carotid arteries and ophthalmic artery can be performed stent assisted loose coil embolization,and others can be preferred craniotomy operation to clip the neck of aneurysms.
ABSTRACT
Objective To investigate the diagnosis and treatment of intracranial venous sinus thrombosis caused by trauma. Methods The clinical data of 13 patients had definite diagnosis by clinic and imaging, were analyzed retrospectively. Three patients received removal of hematoma and bone flap operation; 2 received anticoagulant therapy in early phase and intravenous thrombolysis; 2 accepted intrasinus interventional catheter-directed thrombolysis; ventriculoperitoneal shunt operation was performed in 1 patient for enjoying sub-optimal effects of conservative treatment; and the other 5 patients with transverse sinus embolism accepted conventional treatment for their symptom-free or having mild symptom. Results Intracranial venous sinus thrombosis caused by trauma was likely to locate in the superior sagittal sinus and transverse sinus; these patients mostly manifested as severe diffuse brain swelling combined with a fractured skull, epidural hematoma or intracerebral hematoma. Ten patients got clinical cure, 2 focal symptom and 1 mild mental retardation. Three days to 6 months after treatment, good results were noted in 8 patients performed DSA and in 5 patients performed MRV. Conclusion Early treatment should be given once the definite diagnosis is made in patients with intracranial venous sinus thrombosis caused by trauma, and anticoagulant and thrombolytic therapy are the main methods.
