Jaworska Katarzyna, Dołowy Joanna, Kuśmierska Małgorzata, Kuniej Tomasz, Jaźwiec Przemysław
Department of Medical Radiology and Diagnostic Imaging, 4 Military Clinical Hospital with the Polyclinic in Wrocław, Wrocław, Poland.
Pol J Radiol. 2012 Jan;77(1):50-3. doi: 10.12659/pjr.882581.
A true aneurysym is a dilation of arterial lumen as a consequence of congenital or acquired abnormalities leading to a reduction of mechanical resistance of vascular wall, most commonly caused by its defected structure in the form of absence or weakening of the muscular and/or elastic layer. From the pathophysiological point of view, cerebral aneurysms can be classified as 'saccular' - most commonly occurring, and 'other types', including fusiform/dolichoectatic, dissecting, serpentine, posttraumatic, mycotic and giant aneurysms with or without intra-aneurysmal thrombosis.
We present a rare case of a patient with multiple fusiform dilations of cerebral vessels and giant fusiform aneurysm in supraclinoid segment of the internal carotid artery. The patient presented to hospital because of sudden, severe vertigo with nausea, impaired balance and disturbed vision. Vascular anomalies were detected on CT scanning without contrast. The diagnostic work-up was complemented by CT angiography, MRI and cerebral angiography.
Aneurysm located within the intracranial arteries is one of the most common vascular defects of the brain. The number, size and location of aneurysms are highly variable. Aneurysms can have either supra- or infratentorial location, affecting a single or multiple arteries within one or both brain hemispheres. There is often a correlation between the location of the aneurysm and its etiology, as in case of so-called mirror-image aneurysms. Symmetrically located aneurysms may indicate a defect in vascular structure. Asymmetric location, as in the patient described above, is more likely due to acquired causes, mainly atherosclerosis, but also septic emboli or blood disorders.
真性动脉瘤是由于先天性或后天性异常导致动脉腔扩张，致使血管壁机械阻力降低，最常见的原因是其结构缺陷，表现为肌肉层和/或弹性层缺失或薄弱。从病理生理学角度来看，脑动脉瘤可分为“囊状”（最常见）和“其他类型”，包括梭形/迂曲扩张型、夹层型、蜿蜒型、创伤后型、霉菌性和巨大动脉瘤，有无瘤内血栓形成。
我们报告一例罕见病例，患者脑血管多处梭形扩张，颈内动脉床突上段有巨大梭形动脉瘤。患者因突发严重眩晕伴恶心、平衡障碍和视力紊乱入院。CT平扫发现血管异常。通过CT血管造影、MRI和脑血管造影完善诊断检查。
颅内动脉动脉瘤是最常见的脑部血管缺陷之一。动脉瘤的数量、大小和位置差异很大。动脉瘤可位于幕上或幕下，累及一个或两个脑半球内的单支或多支动脉。动脉瘤的位置与其病因之间通常存在关联，如所谓的镜像动脉瘤。对称位置的动脉瘤可能表明血管结构存在缺陷。不对称位置，如上述患者，更可能是由于后天原因，主要是动脉粥样硬化，也可能是脓毒性栓子或血液疾病。
