Singh H, Thomas J, Hoe W L E, Sethi D S
Department of Otolaryngology, Singapore General Hospital, Singapore.
J Laryngol Otol. 2008 Aug;122(8):e18. doi: 10.1017/S002221510800282X. Epub 2008 Jun 13.
We report a rare case of giant petrous carotid aneurysm.
Case report and a review of the literature regarding treatment options for such aneurysms.
A 30-year-old man presented with epistaxis, headaches and visual disturbance. Definitive diagnosis was achieved by non-invasive imaging techniques, including magnetic resonance angiography and carotid angiography. Carotid angiography demonstrated a giant petrous carotid aneurysm effacing the petrous apex. The aneurysm was obliterated by internal carotid artery ligation, following successful tolerance of the balloon occlusion test. However, despite internal carotid artery ligation, this patient continued to have minor episodes of epistaxis.
Some aneurysms are too large to be treated with endovascular occlusion techniques; in such cases, ligation of the parent vessel is indicated. However, our patient continued to experience persistent, mild epistaxis despite internal carotid artery ligation, as a result of the reperfusion phenomenon.
我们报告一例罕见的巨大岩骨段颈动脉瘤病例。
病例报告及关于此类动脉瘤治疗选择的文献综述。
一名30岁男性出现鼻出血、头痛和视力障碍。通过包括磁共振血管造影和颈动脉血管造影在内的非侵入性成像技术实现了明确诊断。颈动脉血管造影显示一个巨大的岩骨段颈动脉瘤，使岩骨尖消失。在成功耐受球囊闭塞试验后，通过结扎颈内动脉使动脉瘤闭塞。然而，尽管结扎了颈内动脉，该患者仍有轻微鼻出血发作。
一些动脉瘤太大，无法采用血管内闭塞技术治疗；在这种情况下，建议结扎供血血管。然而，我们的患者尽管结扎了颈内动脉，但由于再灌注现象，仍持续出现轻度鼻出血。
