关键词: 小动脉瘤性蛛网膜下腔出血;GDC血管内栓塞治疗;临床随访;影像学随访

Abstract:

Objective  To explore the prognosis of subarachnoid hemorrhage due to small ruptured intracranial aneurysms treated by  Guglielmi detachable coils (GDC) endovascular embolization. Methods  63 cases of subarachnoid hemorrhage due to small ruptured intracranial an eurysms were treated by GDC endovascular embolization. The complications during the treatment, clinical followup outcome and angiographic follow-up outcome were recorded.The data including age, sex, aneurysm location, neurological grade according to Hunt and Hess and Fisher grade, presence of symptomatic cerebral vasospasm, treatment time, acute hydrocephalus classification, delayed hydrocephalus classification and postoperative intracranial pressure were obtained and retrospectively analyzed in order to find the relations with clinical follow-up outcome. Results  Coil protrusion occurred in 1 case, but no aneurysm rupture or thromboembolism occurred during the treatment. The clinical follow-up of the 63 patients showed that no rebleeding occurred, favorable recovery occurred in 39, mild or moderate disability occurred in 12, and severe disability or death occurred in 2. The angiographic follow-up of 42 patients showed that 1 presented neck recanalization of coiled aneurysm and 41 maintained the status of immediate imaging presence after embolization. The presence of symptomatic cerebral vasospasm, Hunt and Hess grade and postoperative intracranial pressure had important predictive value for the clinical outcome. Conclusions  GDC endovascular embolization is safe and effective in the treatment of subarachnoid hemorrhage due to small ruptured intracranial aneurysms, and the presence of symptomatic cerebral vasospasm is a leading factor in deciding the outcome of this disease.

Key words: Subarachnoid hemorrhage due to small ruptured intracranial aneurysms; Guglielmi detachable coils endovascular embolization treatment; Clinical follow-up; Angiographic follow-up