Kuroiwa T, Tanabe H, Takatsuka H, Sakai N, Arai M, Nagasawa S, Ohta T
Department of Neurosurgery, Osaka Mishima Critical Care Medical Center.
No Shinkei Geka. 1992 Aug;20(8):905-8.
A patient who had bilateral distal anterior cerebral artery aneurysms and a right middle cerebral artery aneurysm in association with polycystic kidney and liver disease is reported. A 57-year-old woman was referred to our center with headache and disturbance of consciousness. On admission, her level of consciousness as evaluated by the Japan Coma Scale was 10. CT revealed subarachnoid hemorrhage, especially in the interhemispheric fissures. Right carotid angiography demonstrated bilateral distal anterior cerebral artery aneurysms and a right middle cerebral artery aneurysm. All three aneurysms were clipped in a one-stage procedure. The patient was discharged without any neurological deficits two weeks after the operation. Bilateral distal anterior cerebral artery aneurysms are extremely rare. This is the first report of such aneurysms and a right middle cerebral artery aneurysm in association with polycystic kidney and liver disease. The etiology of these aneurysms is discussed.
本文报告了一名患有双侧大脑前动脉远端动脉瘤及右侧大脑中动脉动脉瘤,并伴有多囊肾和多囊肝疾病的患者。一名57岁女性因头痛和意识障碍被转诊至我院。入院时,根据日本昏迷量表评估,其意识水平为10级。CT显示蛛网膜下腔出血,尤其是在大脑半球间裂。右侧颈动脉血管造影显示双侧大脑前动脉远端动脉瘤和右侧大脑中动脉动脉瘤。在一期手术中对所有三个动脉瘤进行了夹闭。术后两周患者出院,无任何神经功能缺损。双侧大脑前动脉远端动脉瘤极为罕见。这是首例关于此类动脉瘤及右侧大脑中动脉动脉瘤合并多囊肾和多囊肝疾病的报告。本文还讨论了这些动脉瘤的病因。