Wakamoto H, Tabuse M, Miyazaki H, Ishiyama N
Department of Neurosurgery, Hiratsuka City Hospital, 1-19-1 Nanbara, Hiratsuka City, Kanagawa 254-0065, Japan.
No Shinkei Geka. 2001 Jun;29(6):539-43.
A 52-year-old female suddenly developed headache and dizziness. On admission she complained of gait disturbance with dizziness but cranial nerve palsy could not be detected. CT scan revealed a mild high density lesion in the right ambient cistern and the density of the lesion had become much higher 5 days after admission. MRI revealed a homogeneous iso-intense lesion on T1WI, T2WI 2 days after admission and the lesion had changed to homogeneous high. The lesion was suspected to be a fresh thrombus. Right vertebral angiography showed a part of aneurysm arising from the ambient segment of the right superior cerebellar artery and we diagnosed the lesion as a partially thrombosed superior cerebellar artery aneurysm. About forty cases of peripheral superior cerebellar artery aneurysm have been described in the literature, but cases of spontaneous thrombosis of the aneurysms have been very rare. Spontaneous thrombosis of aneurysms was usually thought to occur in large aneurysms, but the aneurysm in our case was not large. We suspected that in our case spontaneous thrombosis may have been caused by occlusion of the parent artery of the aneurysm.
一名52岁女性突然出现头痛和头晕。入院时,她诉说伴有头晕的步态障碍,但未检测到颅神经麻痹。CT扫描显示右侧环池有轻度高密度病变,入院5天后病变密度变得更高。MRI显示入院2天后T1WI、T2WI上有均匀等密度病变,病变已变为均匀高信号。该病变怀疑是新鲜血栓。右侧椎动脉血管造影显示部分动脉瘤起源于右侧小脑上动脉环池段,我们将该病变诊断为部分血栓形成的小脑上动脉动脉瘤。文献中已描述了约40例周围性小脑上动脉动脉瘤,但动脉瘤自发血栓形成的病例非常罕见。动脉瘤自发血栓形成通常被认为发生在大型动脉瘤中,但我们病例中的动脉瘤并不大。我们怀疑在我们的病例中,自发血栓形成可能是由动脉瘤供血动脉闭塞引起的。