Department of Neurosurgery and Stroke Unit, Kanto Medical Center, NTT EC, Tokyo, Japan.
Neurosurgery. 2010 May;66(5):E1025-6. doi: 10.1227/01.NEU.0000367768.41781.CD.
Fusiform aneurysm of the anterior cerebral artery is rare and difficult to treat because of perforators. We encountered a patient with subarachnoid hemorrhage due to rupture of a fusiform aneurysm of the anterior communicating artery complex, and treated this patient with cerebral revascularization.
A 39-year-old man presented with sudden severe headache resulting from subarachnoid hemorrhage. Digital subtraction angiography showed dilatation from the distal A1 segment to the proximal A2 segment of the left anterior cerebral artery. Despite intensive conservative treatment, repetitive angiography showed aneurysmal growth from this dilated portion.
Proximal clipping and clip-on wrapping on the A2 segment was successfully performed with a A3-A3 bypass. He was discharged without neurological deficit.
Cerebral revascularization technique is necessary to achieved appropriate obliteration without ischemic complications.
大脑前动脉梭形动脉瘤因穿支动脉而罕见且难以治疗。我们遇到了一例因前交通动脉复合体梭形动脉瘤破裂导致蛛网膜下腔出血的患者，并对其进行了脑血运重建治疗。
一名 39 岁男性因蛛网膜下腔出血突发严重头痛。数字减影血管造影显示左侧大脑前动脉从 A1 段远端到 A2 段近端扩张。尽管进行了强化保守治疗，但重复血管造影显示该扩张部位的动脉瘤生长。
通过 A3-A3 旁路成功进行了近端夹闭和 A2 段夹闭包裹。他出院时没有神经功能缺损。
为了实现无缺血并发症的适当闭塞，需要进行脑血运重建技术。
