关键词: 颅内血肿, 颅内动脉瘤破裂出血, 脑疝, 血管内治疗, 去骨瓣减压

Abstract: 【Abstract】〓Objective〓To explore the feasibility and clinical value of endovascular embolization combined with craniectomy for hematoma elimination and decompression in treating Hunt-Hess Ⅲ- Ⅳ merger intracranial hematoma in patients with intracranial aneurysm rupture. Methods〓Twelve cases with intracranial aneurysm rupture admitted in our hospital from March 2009 to February 2014 and underwent above endovascular embolization and surgical treatment. The patients need meet following conditions for operation indication,firstly,the patients were with spontaneous subarachnoid hemorrhage along with intracranial hematoma and with Hunt-Hess classification in Ⅲ-grade Ⅳ at the onset. Secondly,the head CT scan showed the brain shift of the midline >0.5 cm but <1.0 cm. Thirdly,cerebral angiogram found intracranial aneurysm and successful embolization and decompression craniectomy. Results〓No case was dead. GOS scores at 3 months of follow-up were 5 points in 7 cases, 4 points in 2 case, 3 points in 2 cases, 2 points one case. Conclusion〓For the patients suffered from intracranial aneurysm rupture, endovascular embolization combined with craniectomy for hematoma elimination and decompression may be a good treatment choice.

Key words: Intracranial hematoma, Intracranial aneurysms bleeding, Endovascular treatment