Objective To study iatrogenic vascular injury and related ischemic complications among 86 patients in 748 cases of minimally invasive neurosurgery.Methods A total of 748 patients received operations of tumor resection, AVM resection or aneurysm clipping. The data of surgical approach, ischemic complications were summarized with follow-up review.Results Twenty-nine patients had postoperative cerebral infarction found by CT follow-up. Fifty-seven patients had transient neurological deficit. Nine patients died in their hospital stay. No patient experienced worsening of symptoms or died during the follow-up period.Conclusion Minimally invasive neurosurgery is not atraumatic and may have ischemic complications following iatrogenic vascular injury. Measures should be taken to protect subarchnoid, cortex and other vessels in the approach.%目的分析748例微创神经外科手术中86例发生医源性血管损伤及脑缺血性并发症的病例.方法 748例患者行了开颅脑肿瘤切除或脑动静脉畸形切除或动脉瘤夹闭手术.分析了手术入路、脑缺血性并发症及随访资料.结果 29例患者术后发生脑梗塞;57例患者术后有脑缺血引起的一过性神经功能障碍;9例患者住院期间死亡.所有患者出院后随访期间无症状加重及死亡.结论神经外科微创手术并非"无创",术中医源性血管损伤可能引起脑缺血性并发症.术中、术后均应采取措施保护手术入路中的蛛网膜下腔、皮层及其他血管.
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