Nussbaum Eric S, Defillo Archie, Mcdonald William, Hanson Sandra, Zelensky Andrea
Department of Neurosurgery, National Brain Aneurysm Center at the John Nasseff Neuroscience Institute, St. Paul, Minnesota, USA ; Minnesota Neurovascular and Skull Base Surgery, Minneapolis, Minnesota, USA.
Centra Care, St. Cloud Hospital, St. Cloud, Minnesota, USA.
Surg Neurol Int. 2014 Jul 11;5:107. doi: 10.4103/2152-7806.136702. eCollection 2014.
Fusiform intracranial aneurysms (FIAs) are uncommon lesions representing less than 15% of all intracranial aneurysms in most large series. Their etiology has been linked to a variety of causes including atherosclerosis, fibromuscular dysplasia, cystic medial necrosis, connective tissue disease, hypertension, diabetes, hyperlipidemia, infection, cardiac myxoma, oral contraceptive use, vasculitis, and lymphoproliferative disorders. The finding of numerous lesions in a single patient is distinctly uncommon.
We describe the unique case of a 47-year-old female who developed multiple FIAs over a 6-year period without an obvious underlying pathology. The patient's medical history was significant for obesity, migraine headaches, insomnia, breast cancer, and chronic skin rash. Various diagnoses were explored including infectious etiologies, autoimmune vasculopathies, malignancy-related causes, connective tissue disorders, and underlying genetic conditions. However, all investigations, including aneurysm wall and skin biopsies were negative or deemed noncontributory toward making a definitive diagnosis.
We report an unusual case of a patient with a normal cerebral angiogram developing numerous, FIAs without obvious underlying etiology over a 6-year period. Close clinical and radiological follow-up is recommended in this case because the natural history of the disease is unclear at this point. The literature regarding potential causes of multiple fusiform intracranial aneuryms is reviewed.
梭形颅内动脉瘤（FIAs）是罕见病变，在大多数大型研究系列中占所有颅内动脉瘤的比例不到15%。其病因与多种因素有关，包括动脉粥样硬化、纤维肌发育不良、囊性中层坏死、结缔组织病、高血压、糖尿病、高脂血症、感染、心脏黏液瘤、口服避孕药使用、血管炎和淋巴增殖性疾病。在一名患者中发现多个病变极为罕见。
我们描述了一名47岁女性的独特病例，该患者在6年时间里出现了多个FIAs，且无明显潜在病理情况。患者的病史包括肥胖、偏头痛、失眠、乳腺癌和慢性皮疹。对各种诊断进行了探索，包括感染性病因、自身免疫性血管病变、恶性肿瘤相关病因、结缔组织疾病和潜在遗传疾病。然而，所有检查，包括动脉瘤壁和皮肤活检均为阴性或被认为对明确诊断无帮助。
我们报告了一例不寻常的病例，一名患者脑血管造影正常，在6年时间里出现多个FIAs，且无明显潜在病因。鉴于目前该病的自然史尚不清楚，建议对该病例进行密切的临床和影像学随访。本文对关于多发性梭形颅内动脉瘤潜在病因的文献进行了综述。
