一名成年烟雾病患者预防性血运重建术后发生脑出血。
Intracerebral hemorrhage after prophylactic revascularization in a patient with adult moyamoya disease.
作者信息
Otawara Yasunari, Ogasawara Kuniaki, Seki Kaoru, Kibe Michihiro, Kubo Yoshitaka, Ogawa Akira
机构信息
Department of Neurosurgery, Iwate Medical University, Morioka, Iwate, 020-8505 Japan.
出版信息
Surg Neurol. 2007 Sep;68(3):335-7; discussion 337. doi: 10.1016/j.surneu.2006.10.061.
BACKGROUND
The effect of revascularization surgery for a patient with moyamoya disease remains controversial.
CASE DESCRIPTION
A 60-year-old man presented with bleeding from asymptomatic moyamoya vessels 10 years after prophylactic revascularization surgery. Cerebral angiography 10 years after the surgery demonstrated that the bilateral direct anastomoses remained effective and a small aneurysm persisted in the anterior choroidal artery. The territories of perfusion through the anastomoses and the size of the aneurysm remained unchanged compared with the angiograms performed 10 years ago.
CONCLUSIONS
Direct revascularization surgery may not always resolve microaneurysms in the moyamoya vessels and prevent rebleeding in patients with hemorrhagic moyamoya disease or bleeding in the nonaffected side.
背景
烟雾病患者血管重建手术的效果仍存在争议。
病例描述
一名60岁男性在预防性血管重建手术后10年，出现无症状烟雾血管出血。术后10年的脑血管造影显示双侧直接吻合仍然有效，脉络膜前动脉存在一个小动脉瘤。与10年前的血管造影相比，通过吻合口的灌注区域和动脉瘤大小未发生变化。
结论
直接血管重建手术可能无法总是消除烟雾血管中的微动脉瘤，也无法预防出血性烟雾病患者再次出血或未受累侧出血。
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