Huh Jun Suk, Park Sang Keun, Shin Jun Jae, Kim Tae Hong
Department of Neurosurgery, Sanggye Paik Hospital, Inje University, College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2007 Oct;42(4):342-5. doi: 10.3340/jkns.2007.42.4.342. Epub 2007 Oct 20.
The azygos anterior cerebral artery, a rare anomaly in the circle of Willis in which only a single vessel supplies the medial aspects of both anterior cerebral hemispheres, is closely associated with saccular aneurysms. We present three cases of azygos anterior cerebral artery aneurysms among the 781 cerebral aneurysms surgically treated at our institution in an 11-year period. These three cases all involved elderly women who presented with subarachnoid hemorrhage. Conventional cerebral angiography and CT angiography revealed small saccular aneurysms at the distal ends of the azygos anterior cerebral arteries. These aneurysms were clipped successfully using a bifrontal interhemispheric approach. Hence, the pathogenesis of these particular aneurysms relating to hemodynamic change, associated anomalies, and surgical pitfalls is discussed with review of literature.
奇静脉型大脑前动脉是 Willis 环中的一种罕见异常，即只有单一血管供应双侧大脑前半球的内侧部分，它与囊状动脉瘤密切相关。我们报告了在 11 年期间，我院手术治疗的 781 例脑动脉瘤中有 3 例奇静脉型大脑前动脉动脉瘤。这 3 例均为老年女性，表现为蛛网膜下腔出血。传统脑血管造影和 CT 血管造影显示奇静脉型大脑前动脉远端有小的囊状动脉瘤。采用双额跨半球入路成功夹闭了这些动脉瘤。因此，结合文献复习，讨论了这些特殊动脉瘤与血流动力学改变、相关异常及手术陷阱有关的发病机制。
