Ikenaga Tohru, Tane Kazuyuki, Ogawa Ryusuke, Takase Takashi
Department of Neurosurgery, Tane General Hospital, 1-2-31 Sakaigawa, Nishi-ku, Osaka 550-0024, Japan.
No Shinkei Geka. 2009 Nov;37(11):1099-103.
We report a case of a 55-year-old female presenting with headache. Neuroradiological investigations revealed a fusiform aneurysm at the M3 part of the right middle cerebral artery. The aneurysm rapidly developed in the course of one year. She underwent a craniotomy for superficial temporal artery middle cerebral artery bypass (STA-MCA bypass) and resection of the aneurysm. Pathological examination suggested that atherosclerosis was a predisposing factor for aneurysm formation. Although she had developed transient dysarthria and left-hand clumsiness after the operation, she was able to be discharged after 26 days with no neurological deficits. On reviewing the literature, fusiform aneurysms seem to be an important cause of subarachnoid hemorrhage and cerebral infarction of unverified origin. Etiology and treatment of spontaneous fusiform aneurysms in a branch of the middle cerebral artery are also discussed.
我们报告一例55岁女性,以头痛为主要症状。神经放射学检查发现右侧大脑中动脉M3段有一个梭形动脉瘤。该动脉瘤在一年内迅速发展。她接受了颞浅动脉大脑中动脉搭桥术(STA-MCA搭桥术)及动脉瘤切除术。病理检查提示动脉粥样硬化是动脉瘤形成的一个诱发因素。尽管术后她出现了短暂的构音障碍和左手笨拙,但26天后她得以出院,且无神经功能缺损。查阅文献发现,梭形动脉瘤似乎是不明原因蛛网膜下腔出血和脑梗死的一个重要原因。本文还讨论了大脑中动脉分支自发性梭形动脉瘤的病因及治疗方法。