Hanakita J, Suwa H, Nishi S, Ohta F, Sakaida H
Department of Neurosurgery, Shizuoka General Hospital.
Neurol Med Chir (Tokyo). 1991 Dec;31(13):972-7. doi: 10.2176/nmc.31.972.
A 52-year-old male was admitted because of right hemiparesis. Computed tomography scan showed a low-density area in the basal ganglia on the left side. Left carotid angiography showed an aneurysm of the extracranial internal carotid artery at the level of the C1-C2 vertebral body. Right carotid angiography also showed an aneurysm of the extracranial internal carotid artery. Because there were neither steno-occlusive changes in the intracranial vessels nor abnormality in the heart, the right hemiparesis seemed to be due to embolism from the extracranial aneurysm. Aneurysmectomy and end-to-end anastomosis of the left internal carotid artery were performed. Extracranial carotid aneurysms are rare conditions. In surgery on these aneurysms, ischemic changes of the brain during arterial clump must be detected and treated. Hypothermia, induced hypertension, and/or internal shunting have been used during arterial clump. The pathogenesis, symptoms, prognosis, and surgical treatments of these aneurysms are discussed.
一名52岁男性因右侧偏瘫入院。计算机断层扫描显示左侧基底节区有低密度区。左侧颈动脉血管造影显示在C1 - C2椎体水平的颅外颈内动脉有一个动脉瘤。右侧颈动脉血管造影也显示颅外颈内动脉有一个动脉瘤。由于颅内血管既没有狭窄闭塞性改变，心脏也没有异常，右侧偏瘫似乎是由颅外动脉瘤栓塞所致。对左侧颈内动脉进行了动脉瘤切除术和端端吻合术。颅外颈动脉动脉瘤是罕见的病症。在这些动脉瘤的手术中，必须检测并处理动脉阻断期间大脑的缺血性改变。在动脉阻断期间已采用低温、诱导性高血压和/或内分流术。本文讨论了这些动脉瘤的发病机制、症状、预后及手术治疗方法。
