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一名轻度头部外伤的年轻患者中既往存在的脑动脉瘤延迟破裂。

Delayed rupture of pre-existing cerebral aneurysm in a young patient with minor head trauma.

作者信息

Hsieh Cheng-Ta, Lin En-Yuan, Tsai Tung-Han, Chiang Yung-Hsiao, Ju Da-Tong

机构信息

Department of Neurological Surgery, Tri-Service General Hospital, 325, Cheng-Kung Road section 2, National Defense Medical Center, Taipei 114, Taiwan, Republic of China.

出版信息

J Clin Neurosci. 2007 Nov;14(11):1120-2. doi: 10.1016/j.jocn.2006.03.014.

Abstract

An intracranial saccular aneurysm is not commonly diagnosed in a patient with head injury. We present a patient with a history of minor head trauma and a CT scan of the brain revealing minimal subarachnoid hemorrhage 17 days prior to admission, complaining of severe headache, dysarthria and focal right limb seizures 3 hours prior to admission. A traumatic aneurysm was suspected based on clinical history and radiological findings including hematoma in the falx region on a CT scan of the brain and an aneurysm of the pericallosal artery on magnetic resonance angiography and four-vessel cerebral angiography. However, at craniotomy, an intracranial non-traumatic saccular aneurysm at the bifurcation of the pericallosal artery was found. The patient recovered fully after successful clipping the aneurysm.

摘要

颅内囊状动脉瘤在头部受伤患者中并不常见。我们报告一例患者,有轻度头部外伤史,入院前17天脑部CT扫描显示少量蛛网膜下腔出血,入院前3小时主诉严重头痛、构音障碍和右侧肢体局灶性癫痫发作。根据临床病史和影像学检查结果怀疑为创伤性动脉瘤,包括脑部CT扫描显示大脑镰区域有血肿,磁共振血管造影和四血管脑血管造影显示胼周动脉有动脉瘤。然而,开颅手术时发现胼周动脉分叉处有一个颅内非创伤性囊状动脉瘤。成功夹闭动脉瘤后,患者完全康复。

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