Choi C H, Cho W H, Choi B K, Lee S W
Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Republic of Korea.
Acta Neurochir (Wien). 2006 Mar;148(3):363-6; discussion 366. doi: 10.1007/s00701-005-0702-4. Epub 2005 Dec 19.
Distal anterior inferior cerebellar artery (AICA) aneurysms are rare and most cases have been treated surgically by clipping, wrapping or trapping. We recently treated this 20-year-old male patient by an endovascular technique. At first, he was treated by intra-aneurysmal embolisation with parent artery preservation. But he presented with rerupture 1 month after embolisation. Follow-up angiography revealed the regrowth of the aneurysm, which was considered as a dissecting aneurysm. We performed occlusion of the AICA just proximal to the aneurysm to prevent fatal rebleeding. He gradually improved and his level of consciousness fully recovered. At 2 year follow up, he had no neurological deficits. We suggest that embolisation of distal AICA aneurysm with parent artery occlusion may be safe and a simple method in the treatment of distal AICA aneurysms.
小脑前下动脉(AICA)远端动脉瘤较为罕见,多数病例已通过夹闭、包裹或结扎等手术方法进行治疗。我们最近采用血管内技术治疗了这名20岁男性患者。起初,我们对其进行了保留载瘤动脉的动脉瘤内栓塞治疗。但栓塞术后1个月他出现了再破裂。随访血管造影显示动脉瘤复发,考虑为夹层动脉瘤。我们在动脉瘤近端对AICA进行了闭塞,以防止致命性再出血。他逐渐好转,意识水平完全恢复。随访2年时,他没有神经功能缺损。我们认为,闭塞载瘤动脉的AICA远端动脉瘤栓塞术可能是治疗AICA远端动脉瘤的一种安全且简单的方法。