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与莫亚莫亚病相关的破裂的外周大脑动脉瘤:系统性审查

Zheng Feng¹, Yongquan Chang², Chao Fu²

¹Department of Pediatrics, The Third Bethune Hospital of Jilin University (China-Japan Union Hospital of Jilin University), Changchun, China.

Journal of stroke

|October 13, 2024

概括

在莫亚莫亚病中破裂的外周大脑动脉瘤是罕见但严重的. 内血管或绕道治疗比保守管理提供更好的结果,有意识受损和再出血预测预后不佳.

科学领域:

神经学神经学
神经外科神经外科
血管神经学血管神经学

背景情况:

莫亚莫亚病 (MMD) 可以出现外周脑动脉瘤 (PPCA) 破裂,这是一个罕见而危险的并发症.
对MMD中PPCA的管理策略进行了讨论,需要对临床数据进行审查.

研究的目的:

总结MMD患者PPCA的临床特征,治疗策略和预后因素.
为了确定与这种患者群体中不良结果相关的风险因素.

主要方法:

1980年至2023年间在PubMed.com上发表的研究的系统文献综述.
使用后勤回归分析来确定不良结果的独立预测因素.

主要成果:

该研究包括48项符合条件的研究中的121名参与者,平均年龄为40.8岁;59.6%是女性.
后部或前部胆道动脉动脉瘤是常见的 (66.1%),经常出现心室内出血 (IVH) (71.1%).
栓塞 (97.1%) 和再血管 (96.3%) 显示出高的有利结果率,而保守的管理有高的再出血率 (26.8%) 和更糟糕的结果.
意识障碍 (OR,8.61) 和动脉瘤再出血 (OR,16.54) 是不良结果的独立预测因素.

结论:

在出血性MMD中,特别是IVH中,PPCA需要仔细考虑.
内血管和旁路治疗是建议的第一线选择;直接手术是血液瘤疏散的替代方案.
个性化治疗选择至关重要,权衡好处与风险,因为意识受损和再出血是显著的不良预后因素.

关键词:

动脉瘤是一个动脉瘤.莫亚莫亚病是莫亚莫亚病的一种疾病.结果结果的结果.风险因素风险因素风险因素系统性审查系统性审查治疗方法治疗方法

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