Ebara M, Tanaka T, Sawauchi S, Morooka S, Yuhki K, Abe T
Department of Neurosurgery, Fuji City General Hospital, Shizuoka, Japan.
No Shinkei Geka. 1999 Nov;27(11):1013-7.
We report a case of an anterior and posterior-inferior cerebellar artery (AICA-PICA) aneurysm. The patient was a 62-year-old woman who suffered from sudden onset of severe headache and nuchalgia. Computed tomography (CT) scan revealed subarachnoid hemorrhage in the ambient cistern and blood clots in the 3rd and 4th ventricles. Vertebral angiography demonstrated an aneurysm located at the distal segment of the left AICA-PICA. Three demensional CT scan was very useful for the decision concerning surgical strategy. The patient underwent bilateral occipital craniectomy and the aneurysm was clipped successfully via the midline suboccipital approach. Her postoperative course was uneventful. Postoperative angiography showed successful clipping of the aneurysm. Distal AICA-PICA aneurysm is a very rare disease and only one case has been reported in the literature. The clinical features, CT findings, and surgical approach of distal AICA-PICA aneurysms are briefly discussed while reviewing the literature.
我们报告一例小脑前下动脉与后下动脉(AICA-PICA)动脉瘤。患者为一名62岁女性,突发剧烈头痛和颈部疼痛。计算机断层扫描(CT)显示环池蛛网膜下腔出血以及第三和第四脑室内有血凝块。椎动脉血管造影显示动脉瘤位于左AICA-PICA的远端。三维CT扫描对手术策略的决策非常有用。患者接受了双侧枕下开颅手术,通过枕下中线入路成功夹闭动脉瘤。其术后过程平稳。术后血管造影显示动脉瘤夹闭成功。远端AICA-PICA动脉瘤是一种非常罕见的疾病,文献中仅报道过一例。在回顾文献的同时,简要讨论了远端AICA-PICA动脉瘤的临床特征、CT表现及手术入路。