Miyagi J, Shigemori M, Hirohata M, Yoshitake Y, Sugita S, Kuramoto S
Department of Neurosurgery, Kurume University School of Medicine.
No Shinkei Geka. 1990 Dec;18(12):1129-33.
Two cases of aneurysms with basilar artery fenestration are presented. A 45 year-old lady had a saccular aneurysm associated with a fenestrated basilar artery. The fenestration was located in the proximal third of the basilar artery. The aneurysm arose from the proximal end of the fenestration, projecting antero-inferiorly. Via a left retromastoid craniectomy, the aneurysm was successfully obliterated through the space between the eighth cranial nerve and the lower cranial nerve complexes. Postoperative deficit in the lower cranial nerves was minimal and transient. The other patient, a 63 year-old lady, had multiple aneurysms arising from the anterior circulation associated with a basilar artery fenestration. These aneurysms were clipped uneventfully. Surgical approach to an aneurysm arising from the basilar artery fenestration is discussed with other related literature. Full study of posterior circulation with multiple projection is mandatory to detect basilar artery fenestration, and the possible presence of saccular aneurysm at the site of the anomaly.
本文报告了两例伴有基底动脉开窗畸形的动脉瘤病例。一名45岁女性患有与基底动脉开窗畸形相关的囊状动脉瘤。开窗位于基底动脉近端三分之一处。动脉瘤起源于开窗的近端，向前下突出。通过左侧乳突后颅骨切除术，经第八颅神经与较低颅神经复合体之间的间隙成功闭塞了动脉瘤。术后较低颅神经的功能缺损轻微且短暂。另一名患者是一名63岁女性，其前循环出现多个与基底动脉开窗畸形相关的动脉瘤。这些动脉瘤均顺利夹闭。结合其他相关文献讨论了处理由基底动脉开窗畸形引起的动脉瘤的手术方法。必须通过多个投照对后循环进行全面研究，以检测基底动脉开窗畸形以及该异常部位可能存在的囊状动脉瘤。
