摘要
小脑出血由小脑供血动脉破裂所致,约占脑出血的10%.高血压是小脑出血最常见的病因,出血的动脉常见为小脑上动脉分支,病变多累及小脑齿状核.临床表现为突发的眩晕、恶心、呕吐,等.大量小脑出血,尤其是蚓部出血时,临床症状较重,可出现头痛、意识下降,甚至出现脑疝、昏迷、死亡等.大量小脑出血是一种危急状况,出现神经功能恶化或脑干受压,无论有无脑室梗阻致脑积水表现,需要施以迅速而有效的手术治疗,尽快清除血肿,不推荐单纯脑室引流.目前大量小脑出血的手术治疗方式已从传统手术向微创手术方式转变.微创手术方式主要包括小骨窗微创颅内血肿清除术、锁孔微创颅内血肿清除术、神经内镜微创血肿清除术、神经导航微创穿刺血肿清除术、软通道微创穿刺血肿清除术、硬通道微创穿刺血肿清除术、脑立体定向微创血肿清除术,等.文中对大量小脑出血的微创手术最新研究进展进行综述.
Cerebellar hemorrhage is mainly caused by the rupture of the cerebellar feeding artery,accounting for about 10%of cerebral hemorrhage.The most common cause of cerebellar hemorrhage is hypertension.The most common cerebellar hemorrhage artery is the branch of the superior cerebellar artery.Massive cerebellar hemorrhage,especially when occurring in the vermis,presents with severe clinical symptoms such as headache,decreased consciousness,and may even lead to brain herniation,coma,or death.Massive cerebellar hemorrhage is a critical condition,which requires rapid and effective surgical treatment regardless of whether there is hydrocephalus caused by ventricular obstruction or brain stem compression.The hematoma should be removed as soon as possible.At present,the surgical treatment of massive cerebellar hemorrhage has changed from the traditional surgery to minimally invasive surgery.Minimally invasive surgical methods for massive cerebellar hemorrhage mainly include small bone window minimally invasive intracranial hematoma removal,keyhole minimally invasive intracranial hematoma removal,neuroendoscopic minimally invasive hematoma removal,neuronavigation minimally invasive hematoma removal,soft channel minimally invasive hematoma removal,hard channel minimally invasive hematoma removal,brain stereotactic minimally invasive hematoma removal,etc.The latest research progress of minimally invasive surgery for massive cerebellar hemorrhage were reviewed.
作者
杨武略
宋安军
任思颖
YANG Wu-lue;SONG An-jun;REN Si-ying(Clinical College of Guizhou Medical University,Guigang 550004,China;Emergency Department,the Affiliated of Guizhou Medical University,Guigang 550004,China)
出处
《中国临床神经科学》
2025年第4期473-476,F0003,共5页
Chinese Journal of Clinical Neurosciences
基金
国家自然科学基金(编号:82360253)
贵州医科大学附属医院2024年国家自然科学基金培育计划项目(编号:gyfynsfc[2024]-04)。
关键词
小脑出血
微创手术
血肿清除术
脑立体定向
高血压
研究进展
cerebellar hemorrhage
minimally invasive surgery
hematoma removal surgery
stereotaxic brain orientation
hypertension
research progress
作者简介
杨武略,硕士研究生,主要从事脑血管病的研究及急诊临床工作;通信作者:宋安军,E-mail:351815967@qq.com。
