Kuroki Kazuhiko, Taguchi Haruyoshi, Yukawa Osamu, Kawamoto Hitoshi, Oshita Jumpei, Sumida Masayuki, Ohba Shinji
Department of Neurosurgery, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi-shi, Hiroshima 738-8503, Japan.
No Shinkei Geka. 2004 Sep;32(9):955-9.
We describe a rare case of subarachnoid hemorrhage due to a ruputured iatrogenic traumatic aneurysm in the cavernous carotid artery, caused by injury during surgery for skull base meningioma that was performed 2 years ago. A 64-year-old woman underwent craniotomy for resection of meningioma of the right sphenoid ridge. During surgery, venous bleeding from the cavernous sinus was easily controlled by packing. Tumor infiltration into the artery had not occurred, and total resection was successfully performed. Two years later, the patient was admitted to our hospital for subarachnoid hemorrhage, without clinical signs of carotid cavernous fistula. Angiography displayed an aneurysm in the cavernous portion of the right carotid artery, which had not been detected on a previous angiogram. The aneurysm was successfully embolized with a GDC via an endovascular approach. Three months later, the residual aneurysm became enlarged and aneurysmal embolization was performed for a second time. Follow-up angiography was performed 7 months after initial embolization, and revealed complete packing.
我们描述了一例罕见的蛛网膜下腔出血病例，其病因是两年前在颅底脑膜瘤手术中受伤导致海绵窦段颈内动脉医源性创伤性动脉瘤破裂。一名64岁女性接受了开颅手术以切除右侧蝶骨嵴脑膜瘤。手术过程中，海绵窦的静脉出血通过填塞很容易得到控制。肿瘤未侵犯动脉，成功进行了全切除。两年后，患者因蛛网膜下腔出血入住我院，无颈动脉海绵窦瘘的临床症状。血管造影显示右侧颈动脉海绵窦段有一个动脉瘤，之前的血管造影未检测到。通过血管内介入方法用GDC成功栓塞了该动脉瘤。三个月后，残余动脉瘤增大，再次进行了动脉瘤栓塞。首次栓塞7个月后进行了随访血管造影，显示完全填塞。
