Kazumata Ken, Terasaka Shunsuke, Ishikawa Tatsuya, Asaoka Katsuyuki, Ushikoshi Satoshi, Ajiki Minoru, Yokoyama Yuka
Department of Neurosurgery, Teine Keijinkai Hospital, 1-12 Teine-ku, Sapporo-shi, Hokkaido 006-8555, Japan.
No Shinkei Geka. 2008 Jun;36(6):523-8.
We report a case of bilateral agenesis of the internal carotid artery which was revealed by oclulomotor palsy and subarachnoid hemorrhage. Angiography showed a ruptured aneurysm of the left P1-2 junction and bilateral absence of the internal carotid artery. In surgery, it was necessary to use temporary clipping several times to adjust the aneurismal clipping. Complete clipping easily compromised the middle cerebral circulation. This case suggested that STA-MCA bypass should be considered in the surgery of agenesis of the internal carotid artery in which the preoperative hemodynamic status is usually normal.
我们报告一例因动眼神经麻痹和蛛网膜下腔出血而发现的双侧颈内动脉缺如病例。血管造影显示左侧P1-2交界处动脉瘤破裂以及双侧颈内动脉缺如。手术中，有必要多次使用临时夹闭来调整动脉瘤夹闭。完全夹闭很容易损害大脑中循环。该病例提示，对于术前血流动力学状态通常正常的颈内动脉缺如手术，应考虑行STA-MCA搭桥术。
