Yoneoka Y, Ezuka I, Takai N, Oda T, Tamura T, Yamashita S
Department of Neurosurgery, Niigata Rosai Hospital, Japan.
Acta Neurochir (Wien). 1998;140(2):185-9. doi: 10.1007/s007010050082.
This report describes a rare case of a distal anterior choroidal artery aneurysm which developed intraventricular haemorrhage without subarachnoid haemorrhage as shown on computerized tomographic (CT) scan. A 69-year-old hypertensive man suddenly became unconscious. An emergency CT scan showed a severe intraventricular haemorrhage and a small round low-dense lesion within the haematoma at the right trigone. The haematoma with obstructive hydrocephalus made the lateral ventricles larger on the right than on the left. CT scan could not detect any subarachnoid haemorrhage. Right interal carotid angiography revealed a saccular aneurysm at the plexal point of the right anterior choroidal artery. We approached the aneurysm and the small round lesion through the trigone via a right temporo-occipital corticotomy. We could clip the aneurysmal neck and remove the intraventricular haematoma and the papillary cystic mass (corresponding to the small round lesion on CT scan) totally in one sitting. Histological examination revealed the aneurysm to be a true one and the papillary cystic mass to be a choroid plexus cyst.
本报告描述了一例罕见的远端脉络膜前动脉动脉瘤病例，计算机断层扫描（CT）显示该动脉瘤引发了脑室内出血但无蛛网膜下腔出血。一名69岁的高血压男性突然昏迷。急诊CT扫描显示严重的脑室内出血，血肿位于右侧三角区，内部有一个小的圆形低密度病变。伴有梗阻性脑积水的血肿使右侧侧脑室比左侧更大。CT扫描未检测到任何蛛网膜下腔出血。右侧颈内动脉血管造影显示右侧脉络膜前动脉丛状点处有一个囊状动脉瘤。我们通过右侧颞枕皮质切开术经三角区处理该动脉瘤和小圆形病变。我们能够夹闭动脉瘤颈部，并一次性完全清除脑室内血肿和乳头状囊性肿物（对应于CT扫描上的小圆形病变）。组织学检查显示动脉瘤为真性，乳头状囊性肿物为脉络丛囊肿。
