[1]刘宝辉 王军民 田道锋 张申起 陈治标 徐海涛 李明昌 蔡 强 吴立权 王 龙 冀保卫 朱晓楠 邓 刚 陈谦学.动脉瘤显微夹闭术后远隔部位小脑出血 13例诊疗体会及文献复习[J].三才期刊采编系统演示平台,2015,1期(04):222-225.[doi:10.3969/j.issn.1007-0478.2015.04.008]
 Liu Baohui,Wang Junmin,Tian Daofeng,et al.Clinical analysis on 13 patients with remote cerebellar hemorrhage and review of the literature[J].,2015,1期(04):222-225.[doi:10.3969/j.issn.1007-0478.2015.04.008]
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动脉瘤显微夹闭术后远隔部位小脑出血 13例诊疗体会及文献复习
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《三才期刊采编系统演示平台》[ISSN:1008-0341/CN:37-1280/R]

卷:
第1期
期数:
2015年04期
页码:
222-225
栏目:
论著
出版日期:
2015-12-31

文章信息/Info

Title:
Clinical analysis on 13 patients with remote cerebellar hemorrhage and review of the literature
文章编号:
1007-0478(2015)04-0222-04
作者:
刘宝辉 王军民 田道锋 张申起 陈治标 徐海涛 李明昌 蔡 强 吴立权 王 龙 冀保卫 朱晓楠 邓 刚 陈谦学
430060 武汉大学人民医院神经外科[刘宝辉 王军民 田道锋 张申起 陈治标 徐海涛 李明昌 蔡 强 吴立权 王 龙 朱晓楠 邓 刚 陈谦学(通信作者)]
Author(s):
Liu Baohui Wang Junmin Tian Daofenget al.
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060
关键词:
动脉瘤 远隔部位小脑出血 临床表现 发生机制 治疗
Keywords:
Aneurysms Remote cerebellar hemorrhage Clinical and imaging manifestation Mechanism Treatment
分类号:
R739 R743
DOI:
10.3969/j.issn.1007-0478.2015.04.008
文献标志码:
A
摘要:
目的 探讨动脉瘤显微夹闭术后远隔部位小脑出血的临床表现、发生机制、治疗及预后。方法 收集2013年9月~2014年12月发生的13例动脉瘤显微夹闭术后远隔性小脑出血的临床病例,分析其临床表现、治疗方法、预后及发生机制。结果 13例患者术后表现为头痛10例,神志恍惚3例,呕吐5例,一侧肢体肌力降低2例,昏迷3例,麻醉苏醒延迟2例。13例患者中,有6例发生于双侧,7例发生于单侧,3例因出血多(超过10 mL),神志昏迷,行二期或者三期手术(颅内血肿清除术+去骨瓣减压术+脑室外引流术),10例经保守治疗出血全部吸收,13例经积极治疗均恢复良好,顺利出院,分析13例手术记录发现,术中均释放脑脊液降低颅内压操作。结论 头痛、呕吐、麻醉苏醒延迟、意识水平下降及肢体肌力降低为动脉瘤显微夹闭术后远隔小脑出血的常见表现。一旦发生远隔部位小脑出血,及早发现,及早治疗,可以降低患者的病死率,改善患者的预后,术中颅内压的骤然改变可能是远隔部位小脑出血发生的机制。
Abstract:
Objectiveto investigate the clinical,imaging manifestation, mechanism, treatment and outcome of remote cerebellar hemorrhage(RCH)after aneurysms microsurgical clipping.Methods A retrospective analysis was made on 13 cases of RCH after aneurysms microsurgical clipping from September 2013 to December 2014 in neurosurgery department of Renmin Hospital Wuhan University. Clinical and imaging manifestation, treatment, outcome and mechanism were analyzed.Results Among 13 patients, headache in 10 cases, mind wanders in 3 cases, vomit in 5 cases, lower muscle strength in one side in 2 cases,unconscious in 3 cases, delay of recovery from general anesthesia in 2 cases. Among 13 cases, RCH happens in both sides in 6 cases and in single side in 7 cases. Cerebellar hemorrhage was more than 10ml and unconscious in 3 cases. 3 cases were done secondary operation or three-stage operation. Blood was absorbed completely in 10 cases through conservative treatment. All 13 cases was good clinical recovery. Cerebrospinal fluid(CSF)was leaked in all 13 cases of RCH.Conclusions Headache, vomit, delay of recovery from general anesthesia, unconscious and lower muscle strength in one side are the most common clinical manifestation in RCH, Early detection and early treatment were important in improving the prognosis of RCH patients. The mechanism of RCH may be leaking of the CSF which induce the intracranial pressure sudden decrease.

参考文献/References:

1 Brockmann MA, Groden C. Remote cerebellar hemorrhage: a review. Cerebellum, 2006, 5(1):64-68.
2 Amini A, Osborn AG, McCall TD, et al. Remote cerebellar hemorrhage. Am J Neuroradiol, 2006, 27(2):387-390.
3 Cloft HJ, Matsumoto JA, Lanzino G, et al. Posterior fossa hemorrhage after supratentorial surgery. AJNR Am J Neuroradiol, 1997, 18(8):1573-1580.
4 严 杰, 徐新民. 术后远隔部位小脑出血一例. 中华神经外科杂志, 2010, 26(12):1070.
5 章凯敏,杜希剑,管汉雄,等. 远隔性小脑出血CT 表现. 放射学实践, 2013, 28(1):38-41.
6 王 晔,郭大文,王德生. 远隔性小脑出血. 沈阳部队医药, 2008, 21(2):134-135.
7 王 诚,卓志平,刘 松. 颅内肿瘤开颅手术并发远隔部位出血分析. 山东医药, 2010, 50(1):14.
8 Ha SH, Kim EM, Ju HM, et al. Remote cerebellar hemorrhage after unruptured cerebral aneurysm surgery: two cases report. Korean J Anesthesiol, 2014, 67(3):213-216.
9 Kerr EE, Prevedello DM, Jamshidi A, et al. Immediate complications associated with high-flow cerebrospinal fluid egress during endoscopic endonasal skull base surgery. Neurosurg Focus, 2014, 37(4):E3.

备注/Memo

备注/Memo:
2015-02-16收稿
更新日期/Last Update: 2015-08-30