Yuen Tanya, Laidlaw John D, Mitchell Peter
Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Vic., Australia.
J Clin Neurosci. 2004 Sep;11(7):771-5. doi: 10.1016/j.jocn.2004.02.004.
Intracavernous carotid mycotic aneurysms are rare and management is dictated by clinical presentation. This case involved a patient presenting with a symptomatic expanding proximal internal carotid artery aneurysm treated with antibiotics and balloon occlusion but with thromboembolic complications resulting in a fatal outcome. Points of discussion include difficulties faced in reaching a diagnosis, management options for mycotic aneurysms and the rationale in this case for choosing endovascular rather than surgical treatment. The use and limitations of trial balloon occlusion are discussed as well as complications of vessel occlusion, in particular thromboembolism. Also discussed is the importance of surveillance imaging and the impact of sepsis on overall management.
海绵窦段颈内动脉霉菌性动脉瘤罕见，其治疗取决于临床表现。本病例患者表现为近端颈内动脉动脉瘤有症状且不断扩大，接受了抗生素治疗和球囊闭塞，但出现血栓栓塞并发症，导致死亡。讨论要点包括诊断面临的困难、霉菌性动脉瘤的治疗选择以及本病例选择血管内治疗而非手术治疗的理由。还讨论了试验性球囊闭塞的使用和局限性以及血管闭塞的并发症，尤其是血栓栓塞。此外，还讨论了监测成像的重要性以及脓毒症对整体治疗的影响。
