Preul M, Tampieri D, Leblanc R
Division of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada.
Surg Neurol. 1992 Nov;38(5):347-52. doi: 10.1016/0090-3019(92)90020-n.
We describe an unusual case of a giant pericallosal artery aneurysm, producing psychomotor depression from mass effect, associated with a smaller aneurysm of the anterior communicating artery, a dural arteriovenous fistula, and a meningioma. Magnetic resonance imaging (MRI) and cerebral angiography demonstrated the giant aneurysm and the meningioma. Cerebral angiography provided a detailed appreciation of the cerebral circulation, including both aneurysms, the dural arteriovenous fistula, and the potential collateral supply to the involved anterior cerebral distribution. The anterior communicating artery aneurysm was successfully clipped as was the distal anterior cerebral branch supplying the giant aneurysm before its resection. The patient made a full recovery but with persisting, slight dysphasia. We conclude that computed tomography, cerebral angiography, and MRI are of specific value in the assessment of giant aneurysms, but only angiography can provide detailed characterization of the aneurysm and demonstrate other possible cerebrovascular pathology such as multiple aneurysms and arteriovenous fistulas.
我们描述了一例罕见的巨大胼周动脉瘤病例，该动脉瘤因占位效应导致精神运动性抑郁，同时伴有前交通动脉瘤、硬脑膜动静脉瘘和脑膜瘤。磁共振成像（MRI）和脑血管造影显示了巨大动脉瘤和脑膜瘤。脑血管造影详细显示了脑循环情况，包括两个动脉瘤、硬脑膜动静脉瘘以及向受累大脑前动脉分布区的潜在侧支供血。前交通动脉瘤在切除巨大动脉瘤之前成功夹闭，供应巨大动脉瘤的大脑前动脉远端分支也成功夹闭。患者完全康复，但仍有持续的轻度言语困难。我们得出结论，计算机断层扫描、脑血管造影和MRI在评估巨大动脉瘤方面具有特定价值，但只有血管造影能够提供动脉瘤的详细特征，并显示其他可能的脑血管病变，如多发动脉瘤和动静脉瘘。
