Lee Seung Hwan, Bang Jae Seung
Department of Neurosurgery of East-West Neo Medical Center, Kyung Hee University, School of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2007 Dec;42(6):478-80. doi: 10.3340/jkns.2007.42.6.478. Epub 2007 Dec 20.
Unruptured non-traumatic dissecting aneurysm in the M4 segment of the middle cerebral artery (MCA) accompanied by complete occlusion of the ipsilateral internal cerebral artery (ICA) has never been reported. A 41-year-old man presented with an infarction manifesting as left-sided weakness and dysarthria. Magnetic resonance angiography revealed a subacute stage infarction in the right MCA territory and complete occlusion of the right ICA. Angiography demonstrated aneurysmal dilatation of the M4 segment of the right MCA. Surgery was performed to prevent hemorrhage from the aneurysm. The aneurysm was proximally clipped guided by Navigation-CT angiography and flow to the distal MCA was restored by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report this rare case with literature review.
大脑中动脉(MCA)M4段未破裂的非创伤性夹层动脉瘤伴同侧大脑内动脉(ICA)完全闭塞的情况此前从未有过报道。一名41岁男性因梗死就诊,表现为左侧肢体无力和构音障碍。磁共振血管造影显示右侧MCA区域亚急性期梗死及右侧ICA完全闭塞。血管造影显示右侧MCA的M4段呈瘤样扩张。为预防动脉瘤出血进行了手术。在导航CT血管造影引导下近端夹闭动脉瘤,并通过颞浅动脉-大脑中动脉(STA-MCA)吻合术恢复了MCA远端的血流。我们报告这一罕见病例并进行文献复习。