外侧膝状体后脉络膜动脉瘤自发性丘脑出血。
Spontaneous thalamic hemorrhage from a lateral posterior choroidal artery aneurysm.
机构信息
Division of Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada; Labatt Family Centre of Excellence in Brain Injury and Trauma Research Toronto, Ontario, Canada; Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
出版信息
World Neurosurg. 2013 Dec;80(6):900.e1-6. doi: 10.1016/j.wneu.2013.02.006. Epub 2013 Feb 8.
BACKGROUND
The authors report a case of lateral posterior choroidal artery pseudoaneurysm that caused a spontaneous thalamic hemorrhage. The case supports obtaining computed tomographic angiography (CTA) even in seemingly routine cases of hypertensive hemorrhage and demonstrates a possibly unreported type of aneurysm causing thalamic hemorrhage.
CASE DESCRIPTION
A 60-year-old man with a history of hypertension presented with a spontaneous right thalamic hemorrhage, and CTA showed a focus of contrast inside the hematoma. One month later, the patient was well but a CTA showed that the hematoma had resolved but that there was enlargement of the contrast-enhancing lesion in the thalamus. Catheter angiography showed an aneurysm of the lateral posterior choroidal artery. This was excised via an occipital interhemispheric supratentorial subcallosal approach. The patient recovered fully and returned to work 3 months later.
CONCLUSION
The case shows the need to carefully review CTA after ICH, even in cases of seemingly typical hypertensive ICH.
背景
作者报告了一例外侧后脉络膜动脉假性动脉瘤引起的自发性丘脑出血病例。该病例支持即使在看似常规的高血压性出血病例中也获取计算机断层血管造影（CTA），并展示了一种可能未报道的引起丘脑出血的动脉瘤类型。
病例描述
一名 60 岁男性，有高血压病史，表现为自发性右侧丘脑出血，CTA 显示血肿内有一处造影剂焦点。1 个月后，患者情况良好，但 CTA 显示血肿已吸收，但丘脑内增强病变扩大。导管血管造影显示外侧后脉络膜动脉动脉瘤。通过枕叶间脑额下入路切除。患者完全康复，3 个月后恢复工作。
结论
该病例表明即使在看似典型的高血压性 ICH 病例中，ICH 后也需要仔细复查 CTA。
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