颅内动脉瘤的症状表现

张永力 刘方军 【关键词】脑动脉瘤症状；脑出血；头疼；呕吐；诱因； Before aneurysm rupture bleeding, 90% of the patients had no obvious signs and symptoms, often a further development of aneurysm volume expansion. Oculomotor nerve paralysis is traffic artery aneurysm after most positioning aura are broken. After aneurysm rupture bleeding, bleeding place by a blood clot solidification contraction and vasospasm and reach the purpose of hemostasis, and promoting effect of cerebrospinal fluid, break to stop the bleeding. In 1 ~ 2 weeks after the hemorrhage, rupture in the web of fragile, a blood clot is liquefied, because the mouth of the arterial wall rupture fibrosis is not strong, so prone to bleeding again. 动脉瘤在破裂出血之前，90%的病人没有明显的症状和体征，常常进一步发展，出现动 脉瘤体积扩大。动眼神经麻痹是后交通动脉的动脉瘤最有定位意义的先兆破裂症状。动脉 瘤破裂出血后，出血处由血凝块凝固以及血管痉挛收缩而达到止血的目的，加之脑脊液的 促进作用，破裂处停止出血。在出血后 1～2 周，破裂处的纤维网脆弱、血凝块发生液化， 由于此时动脉壁破裂口的纤维化尚不牢固，故容易发生再次出血。 Some patients often have obvious cause, in front of the aneurysm rupture, such as heavy manual labor, cough, forcibly defecate, running, drunk, emotional, anxiety, sex, etc. In more cases, the bleeding is when there is no obvious cause sudden, even during sleep. Most patients sudden onset, usually with 脑血管病友之家：QQ 群：249934975 脑血管疾病病友交流的平台; headache and disturbance of consciousness as the most common and most outstanding performance. 部分病人在动脉瘤破裂前常有明显的诱因，如重体力劳动、咳嗽、用力大便、奔跑、 酒后、情绪激动、忧虑、性生活等。在更多的情况下，出血是在没有明显诱因时突然发生 的，甚至发生在睡眠中。多数病人突然发病，通常以头痛和意识障碍为最常见和最突出的 表现。 Compression symptoms: cerebral aneurysms because of different parts and corresponding compression symptoms. Tumors had increased after can appear have a headache, is located in the lateral orbital, a pulsatile; May also appear ill side exophthalmos, drooping eyelids, eye limited outreach, hemiparesis, and motor aphasia, mental disorders, diabetes insipidus, seizures and nasal bleeding, etc. 压迫症状:脑动脉瘤因为不同的部位而产生相应的压迫症状。瘤体增大后可出现头痛， 位于病侧眼眶，呈搏动性;亦可出现病侧眼球突出、眼睑下垂、眼球外展受限、轻偏瘫、运 动性失语、精神障碍、尿崩症、癫痫发作和鼻出血等表现。 Rupture aura: aneurysm after expansion, often limitations caused headaches, sore eyes, vision loss, nausea, pain in the neck stiffness, dizziness and move 北京三博脑血管病专家张永力 or sensory disturbance, etc., may be an aura of cerebral aneurysm rupture. When the aneurysm more than 2.5 cm in diam., can lead to increased intracranial pressure symptoms. 破裂先兆:动脉瘤扩张后，常引起局限性头痛、眼痛、视力减退、恶心、颈部僵痛、眩 晕和动动或感觉障碍等，可能为脑动脉瘤破裂的先兆。当动脉瘤直径超过 2.5 厘米时，可 引起颅内压增高症状。 Bleeding symptoms: brain aneurysm rupture after subarachnoid hemorrhage symptoms, such as severe headache, nausea and vomiting, meningeal stimulation, fever, convulsions, consciousness and the performance of the oculomotor nerve palsy. Often repeated hemorrhage after brain aneurysm rupture and hemorrhage patients symptoms after again is aggravating, disturbance of consciousness, or appeared new signs and symptoms. 出血症状:脑动脉瘤破裂后，出现蛛网膜下腔出血症状，如剧烈头痛、恶心呕吐、脑膜 刺激征、发热，可伴抽搐、意识障碍及动眼神经麻痹的表现。脑动脉瘤破裂后常反复出血， 再出血后病人症状再次加重，意识障碍加深，或又出现新的症状体征。 张永力主任北京三博脑科医院(首都医科大学第十一临床医学院)神经外科北京香山一 棵松 50 号 100093