Sugino Toshiyuki, Yamamoto Kazuo, Kidooka Minoru, Otsuka Shin-ichi
Department of Neurosurgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu-city, Shiga 520-8511, Japan.
No Shinkei Geka. 2002 Nov;30(11):1211-5.
A case is reported of a patient with simultaneous subdural hematoma and intracerebral hemorrhage associated with a ruptured intracranial mycotic aneurysm. A 65-year-old woman, with a history of low grade fever for over a month, presented with disturbance of consciousness. A CT showed bilateral acute subdural hematomas and parenchymal hematomas in the occipital lobes. Cerebral angiography demonstrated a distal middle cerebral aneurysm. Cardiac ultrasonography showed a verruca at the mitral valve. The incidence of ruptured mycotic aneurysm presenting with acute subdural hematoma is extremely rare. To our knowledge, there have been only seven cases. The present case is discussed with reference to a review of the literature.
报告了一例同时患有硬膜下血肿和脑出血并伴有颅内霉菌性动脉瘤破裂的患者。一名65岁女性,有持续一个多月的低热病史,出现意识障碍。CT显示双侧急性硬膜下血肿和枕叶实质内血肿。脑血管造影显示大脑中动脉远端动脉瘤。心脏超声检查显示二尖瓣有赘生物。霉菌性动脉瘤破裂并伴有急性硬膜下血肿的发生率极为罕见。据我们所知,仅有七例。本文结合文献复习对该病例进行了讨论。