创伤性内动脉瘤:内血管时代的当代综述
Eric A Grin1, Adhith Palla1, Caleb Rutledge1
1Department of Neurosurgery, NYU Grossman School of Medicine, New York, New York, USA.
概括
创伤性内动脉瘤 (TICAs) 是罕见但危险的. 早期诊断和多学科管理,越来越倾向于内血管技术,对于TBI患者的更好的结果至关重要.
科学领域:
- 神经外科 神经外科
- 血管神经学 血管神经学
- 放射学 放射学是一门学科.
背景情况:
- 创伤性内动脉瘤 (TICAs),通常是伪动脉瘤,是创伤性脑损伤 (TBI) 或阳性事件的罕见但严重后果.
- 它们的独特发育,延迟发病,以及显著的破裂潜力构成了相当大的诊断和治疗障碍.
- 了解TICA的发病,诊断和治疗对于管理这些高风险的血管病变至关重要.
研究的目的:
- 审查和综合有关创伤性内动脉瘤的发病,诊断和治疗的现有证据.
- 强调先进的成像和内血管干预在管理TICAs中的不断变化的作用.
- 为管理TBI和疑似内动脉瘤患者的临床医生提供全面的概述.
主要方法:
- 进行了PubMed的系统文献搜索,并补充了手动引用审查.
- 所有研究设计和出版日期都被考虑了.
- 数据被主题综合,涵盖流行病学,病理生理学,成像方法,治疗策略 (内血管和外科手术) 和随访协议.
主要成果:
- TICA通常发生在直接损伤或固定动脉段的部位,通常呈现微妙和延迟.
- 数字减去血管造影仍然是诊断的黄金标准,尽管初始成像可能是负面的.
- 内血管方法,特别是流量转移,由于它们的最小侵入性和在血管重建中的有效性,越来越受欢迎,而开放式手术则保留给复杂的病例.
结论:
- 创伤性内动脉瘤是不同的,高风险的脑血管事件,需要及时诊断和量身定制的多学科护理.
- 内血管治疗方法正在成为首选的治疗策略.
- 需要进行进一步的研究,以制定TICA患者的最佳监视成像指南.
相关概念视频
01:26Aneurysm III: Interprofessional Care
249
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
249
01:22Aneurysm IV: Nursing Management
364
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
364
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
258
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
258
01:30Aneurysm I: Introduction
336
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
336
01:25Aortic Regurgitation III: Medical Management
383
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
383