Hashimoto Masanori, Urasaki Eiichirou, Tsujigami Satoshi, Yokota Akira
Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Fukuoka.
Neurol Med Chir (Tokyo). 2002 Jan;42(1):23-6. doi: 10.2176/nmc.42.23.
A 65-year-old woman presented with a ruptured saccular aneurysm associated with a rare variation of the posterior communicating artery (PcoA), partially duplicated PcoA. The PcoA with this variation forked just distal to the aneurysmal neck, and the two branches independently merged into the posterior cerebral artery. Initial clipping failed to isolate the aneurysm from one of the two branches, so the aneurysmal dome continued to pulsate and bleed. Temporary clipping of the proximal internal carotid artery revealed the fork of the two branches just distal to the aneurysmal neck. A curved Yasargil clip was used to clip the aneurysm and preserve the PcoA and branches. Careful observation of this PcoA variation is needed because the arterial structures may be hidden by the thickened arachnoid membrane.
一名65岁女性因囊状动脉瘤破裂就诊，该动脉瘤与后交通动脉（PcoA）的罕见变异——部分重复的PcoA相关。具有这种变异的PcoA在动脉瘤颈部远端分叉为两支，这两个分支分别独立汇入大脑后动脉。初次夹闭未能将动脉瘤与两个分支之一隔开，因此动脉瘤瘤顶持续搏动并出血。临时夹闭颈内动脉近端后发现，在动脉瘤颈部远端两支动脉分叉。使用一枚Yasargil弯夹夹闭动脉瘤并保留PcoA及其分支。由于动脉结构可能被增厚的蛛网膜掩盖，因此需要仔细观察这种PcoA变异情况。
