Department of Neurosurgery, National Organization Nagasaki Medical Center, Nagasaki, Japan.
J Stroke Cerebrovasc Dis. 2012 Nov;21(8):907.e5-8. doi: 10.1016/j.jstrokecerebrovasdis.2011.07.017. Epub 2011 Oct 6.
Dolichoectasia of the intracranial arteries is a rare condition, and the vertebrobasilar system and the internal carotid artery are the most commonly involved structures. We report a rare case of idiopathic dolichoectasia of the anterior cerebral artery in a 22-year-old female. The patient caused an automobile accident and was brought to our hospital in an ambulance. A computed tomography scan and magnetic resonance imaging revealed no fresh lesions, but showed a prominent serpentine structure with calcification and flow void in the region of the interhemispheric fissure, which was suspicious for arteriovenous malformation or arteriovenous fistula. Cerebral angiography demonstrated extensive dilatation of the anterior cerebral artery, but no evidence of arteriovenous malformation or arteriovenous fistula. Single photon emission computed tomography revealed hypoperfusion of the right frontal lobe at rest. Electroencephalography showed no epileptic discharge. The patient's course was uneventful, and she was discharged with no neurologic deficit. There are few reports of hemodynamic changes in cases of dolichoectasia. In the diagnosis of cerebral dolichoectasia, cerebral hemodynamics should be examined carefully in addition to evaluating vascular disease by angiography.
颅内动脉迂曲扩张是一种罕见的疾病，椎基底动脉系统和颈内动脉是最常受累的结构。我们报告了一例 22 岁女性特发性大脑前动脉迂曲扩张的罕见病例。该患者因车祸被救护车送往我院。计算机断层扫描和磁共振成像显示无新鲜病变，但显示大脑半球间裂区域有一个突出的蛇形结构，伴有钙化和血流空影，提示动静脉畸形或动静脉瘘。脑血管造影显示大脑前动脉广泛扩张，但无动静脉畸形或动静脉瘘的证据。单光子发射计算机断层扫描显示静息时右侧额叶灌注不足。脑电图无癫痫放电。患者的病程平稳，无神经功能缺损出院。在迂曲扩张的病例中，很少有血流动力学变化的报道。在诊断大脑迂曲扩张时，除了通过血管造影评估血管疾病外，还应仔细检查脑血流动力学。
