Hsieh Cheng-Ta, Lin En-Yuan, Tsai Tung-Han, Chiang Yung-Hsiao, Ju Da-Tong
Department of Neurological Surgery, Tri-Service General Hospital, 325, Cheng-Kung Road section 2, National Defense Medical Center, Taipei 114, Taiwan, Republic of China.
J Clin Neurosci. 2007 Nov;14(11):1120-2. doi: 10.1016/j.jocn.2006.03.014.
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.
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。
