Intracranial aneurysms are known as intracranial "time bombs" because of their high risk. Recently, the Department of Neurosurgery of the Second Affiliated Hospital of Xi'an Medical College received a patient with headache and nausea and vomiting who was diagnosed with multiple intracranial aneurysm rupture and bleeding, and removed multiple "time bombs" after aneurysm clipping surgery + drilling drainage treatment.
Master Li, a 58-year-old native of Xi'an, has been farming in his early years, and has been doing temporary work in his spare time. In recent years, Master Li has gradually grown older, and the children have also formed their own families and are ready to retire.
"I don't usually do any heavy work, just grow vegetables and chop firewood," said Master Li's son, who has been in good health, and although he occasionally has a cold and fever, he is still healthy.
One day last month, while chopping firewood at Master Li's home, he suddenly had a headache and nausea for no reason.
"I was chopping firewood, and suddenly I felt a terrible headache, nausea and vomiting," Master Li recalled.
The lover hurriedly helped Master Li back to the room and called the child to go home.
It had been more than an hour since the children had returned home, and Master Li's symptoms had not eased. Looking at the painful appearance of his father, who has supported the whole family for decades, Master Li's son did not hesitate and hurriedly dialed 120 to send his father to the Second Affiliated Hospital of Xi'an Medical College for treatment.
Emergency head CT shows bilateral lateral fissure cisterns and partial sulci high-density opacities, suggesting subarachnoid hemorrhage. For further treatment, Master Li was admitted to the Department of Neurosurgery.
"Ruptured intracranial aneurysms are the primary cause of subarachnoid haemorrhage, and the first thing we suspect is a ruptured aneurysm." Dr. Jia Lipeng, a neurosurgeon, said: "Therefore, it is urgent to arrange for the patient to complete the examination, clarify the diagnosis, and then do further treatment. ”
Imaging examinations showed that there were aneurysms in the bifurcation of the left internal carotid artery, anterior communicating artery, and right ophthalmic artery; Subarachnoid hemorrhage is caused by ruptured aneurysm at the bifurcation of the left internal carotid artery!
Subarachnoid hemorrhage
CTA shows aneurysm location
Multiple intracranial aneurysms
The presence of two or more aneurysms in the skull, mostly occurring in the middle cerebral artery bifurcation, anterior communicating artery, and middle cerebral artery M1 segment, has a 2-3 times higher risk of rupture than a single patient, and has a worse prognosis than a single aneurysm.
Schematic diagram of an intracranial aneurysm
Schematic diagram of multiple intracranial aneurysms
"The patient's multiple intracranial aneurysm rupture and subarachnoid hemorrhage are clearly diagnosed, and it is recommended to operate on the aneurysm and hemorrhage as soon as possible," Yuan Zhihai, deputy chief physician, said in the discussion of the condition. ”
Rupture and bleeding of intracranial aneurysm
The discussion of the department's condition believes that Master Li's diagnosis is clear and the indications for surgery are clear, and it is recommended that Deputy Chief Physician Yuan Zhihai perform "left wing point supracurranoconarctomy multiple aneurysm clipping + right ventricle drilling and drainage" for the patient as soon as possible, not only to do targeted treatment, but also to deal with the hidden danger of long-term rupture!
Clipping of intracranial aneurysm
Treatment of multiple aneurysms
- Ruptured aneurysms are sure to be treated!
- After evaluation of an unruptured aneurysm, it is considered manageable by concurrent surgery to reduce the risk of re-rupture of the aneurysm during staging surgery.
The slightest mistake in the operation of intracranial aneurysm clipping may lead to serious complications and even death after the operation, which is a test of the doctor's technical level and psychological quality.
Deputy Chief Physician Yuan Zhihai has rich surgical experience and successfully completed the operation for Master Li with the assistance of Dr. Jia Lipeng.
The operation was successful, and Master Li woke up from anesthesia to indicate that the preoperative symptoms were significantly relieved!
Imaging the day after surgery
After a period of recovery, Master Li's physical condition greatly improved, and he was discharged from the hospital to recuperate.
After being discharged, Master Li strictly followed the discharge instructions for regular re-examination, and the results showed that his condition was stable!
First review
Second review
Tips
Once one of the multiple intracranial aneurysms ruptures, the other aneurysm is highly likely to "explode". Therefore, it needs to be dealt with in a timely manner, and there must be no fluke mentality.