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小脑前下动脉动脉瘤:六例病例报告及文献复习。

Anterior inferior cerebellar artery aneurysms: six cases and a review of the literature.

机构信息

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

Neurosurg Rev. 2012 Jan;35(1):111-9; discussion 119. doi: 10.1007/s10143-011-0338-1. Epub 2011 Jul 12.

Abstract

Aneurysms of the anterior inferior cerebellar artery are rare. Six cases of anterior inferior cerebellar artery (AICA) aneurysms treated at one center are presented. The six cases of AICA aneurysms were surgically treated. The clinical features, surgical process, complications, and follow-up are demonstrated. Six patients with six AICA aneurysms were presented including one AVM accompanied aneurysm and one giant aneurysm. Five aneurysms had ruptured, one was unruptured. Five patients presented with subarachnoid hemorrhage (SAH) including two with intraventricular hemorrhaging and one with an intraparenchymal hematoma. One aneurysm was proximal, two were distal, and three were meatal. All cases were treated surgically. Retrosigmoid and far-lateral craniectomy were included. Navigation was accomplished through intraoperative ultrasound and fluorescent angiography. Resection of the aneurysm after clipping was significant. The most common postoperative deficit involved the cranial nerves in four patients. Follow-up was available for all patients for a mean of 68 months. SAH is the most common presentation. The relationship between the aneurysms and the meatus is an important factor for neurological dysfunction. 3D-CTA and MRA may be considered as diagnostic adjuncts. Several special surgical techniques used in our cases are worth noting. Endovascular therapy for AICA aneurysms is in the process of development and should be reserved for special cases.

摘要

小脑前下动脉动脉瘤很少见。本文报道了在一个中心治疗的 6 例小脑前下动脉(AICA)动脉瘤。这 6 例 AICA 动脉瘤均接受了手术治疗。本文展示了这些病例的临床特征、手术过程、并发症和随访情况。6 例 AICA 动脉瘤患者中包括 1 例动静脉畸形伴发的动脉瘤和 1 例巨大动脉瘤。5 个动脉瘤已破裂,1 个未破裂。5 例患者表现为蛛网膜下腔出血(SAH),其中 2 例合并脑室出血,1 例合并脑实质血肿。1 个动脉瘤位于近端,2 个位于远端,3 个位于内听道口。所有病例均接受了手术治疗。包括乙状窦后和远外侧开颅术。术中采用超声和荧光血管造影进行导航。夹闭后切除动脉瘤效果显著。4 例患者术后最常见的神经功能缺损涉及颅神经。所有患者的平均随访时间为 68 个月。SAH 是最常见的表现。动脉瘤与内听道的关系是导致神经功能障碍的重要因素。3D-CTA 和 MRA 可作为辅助诊断手段。我们在病例中使用了几种特殊的手术技术,值得注意。AICA 动脉瘤的血管内治疗正在发展中,应保留用于特殊情况。

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