Egemen Emrah, Massimi Luca, Di Rocco Concezio
Neurosurgery Department, Gazi University Medical School, Beşevler, 06500 Ankara, Turkey.
Childs Nerv Syst. 2012 Dec;28(12):1997-2004. doi: 10.1007/s00381-012-1907-5. Epub 2012 Sep 4.
Iatrogenic aneurysms are very rare in children. Characteristic clinical manifestations are variable and asymptomatic course is possible especially for fusiform dilatation of internal carotid artery. Even though radiological diagnosis is easy, the management of iatrogenic intracranial aneurysm is still a subject for discussion.
Fusiform dilatations of internal carotid artery were diagnosed on three pediatric patients during follow-up imaging after primary surgery for suprasellar-parasellar tumor. All patients were asymptomatic. Conservative treatment was proposed because the lesion did not show any progression in subsequent examinations. Patients are stable under conservative treatment.
Iatrogenic aneurysm may have an unusual presentation and their therapy still remains unclear. Fusiform dilatation of internal carotid artery rarely causes symptoms and there is no published paper of subarachnoid bleeding. Treatment would be difficult, since the main arterial branches arise from the dilated carotid segment. Conservative treatment is a choice only if aneurysm has no progression or in case of spontaneous healing. Intervention should be performed only in case of progression or if the aneurysm becomes symptomatic.
医源性动脉瘤在儿童中非常罕见。其特征性临床表现多样，尤其是颈内动脉梭形扩张时可能出现无症状病程。尽管放射学诊断容易，但医源性颅内动脉瘤的治疗仍存在争议。
在三例鞍上-鞍旁肿瘤初次手术后的随访影像检查中诊断出颈内动脉梭形扩张。所有患者均无症状。由于病变在后续检查中未显示任何进展，故建议采取保守治疗。患者在保守治疗下情况稳定。
医源性动脉瘤可能有不寻常的表现，其治疗仍不明确。颈内动脉梭形扩张很少引起症状，且尚无蛛网膜下腔出血的相关报道。由于主要动脉分支起源于扩张的颈动脉段，治疗将很困难。仅当动脉瘤无进展或出现自发愈合时，保守治疗才是一种选择。仅在动脉瘤进展或出现症状时才应进行干预。
