Winston Chong W K
Interventional Neuroradiology Unit, Diagnostic Imaging, Monash Medical Centre, Locked Bag, Clayton, Victoria, Australia -
Interv Neuroradiol. 2008 Nov 11;14 Suppl 2(Suppl 2):65-74. doi: 10.1177/15910199080140s212. Epub 2009 Jan 2.
Treatment and prognosis of 14 patients of posterior fossa arterial dissections (AD) and dissecting aneurysms (DA) in one institution was reviewed. Internal trapping of aneurysm was performed for six patients presenting with SAH (three Vertebral, one posterior cerebral, one posterior inferior cerebellar, one anterior inferior cerebellar DA). The patency of the parent arteries was preserved in four DA patients with SAH (two Vertebral, two Basilar DA), 1 incidental vertebral DA, and one DA patient with brainstem infarction using stents and coils (four patients) or coils only (two patient). Proximal occlusion of parent artery was performed in a vertebral DA with SAH. One patient with a superior cerebellar DA presented with a midbrain infarct developed SAH with spontaneous occlusion of the aneurysm two weeks later. Of the 14 cases, ten were angiographically stable or cured during a follow up period of four to 70 months. one spontaneously resolved and two recurred. There was one death.
回顾了一家机构中14例后颅窝动脉夹层（AD）和夹层动脉瘤（DA）患者的治疗及预后情况。对6例出现蛛网膜下腔出血（SAH）的患者（3例椎动脉、1例大脑后动脉、1例小脑后下动脉、1例小脑前下动脉DA）进行了动脉瘤内套扎术。4例SAH的DA患者（2例椎动脉、2例基底动脉DA）、1例偶然发现的椎动脉DA以及1例脑干梗死的DA患者使用支架和弹簧圈（4例患者）或仅使用弹簧圈（2例患者）保留了供血动脉的通畅。对1例SAH的椎动脉DA进行了供血动脉近端闭塞术。1例小脑上动脉DA患者出现中脑梗死，两周后发生SAH且动脉瘤自发闭塞。在14例病例中，10例在4至70个月的随访期内血管造影显示稳定或治愈。1例自发缓解，2例复发。有1例死亡。
