蛛网膜下腔出血后孤立性颈段脊髓前动脉动脉瘤的自发消退。
Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage.
作者信息
Pahl Felix Hendrik, de Oliveira Matheus Fernandes, Rotta Marcus Alexandre Cavalcanti, Dias Guilherme Marcos Soares, Rezende André Luiz, Rotta José Marcus
机构信息
Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, IAMSPE, São Paulo, Brazil.
出版信息
Surg Neurol Int. 2014 Sep 25;5:139. doi: 10.4103/2152-7806.141776. eCollection 2014.
BACKGROUND
Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge.
CASE DESCRIPTION
We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection.
CONCLUSION
We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive.
背景
孤立性颈段脊髓前动脉动脉瘤极为罕见。据我们所知，继发于此类病变的蛛网膜下腔出血（SAH）仅在6例中有过描述。
病例描述
我们描述了1例既往血管造影正常的患者因脊髓前动脉动脉瘤破裂导致SAH的不寻常临床表现。由于动脉瘤的位置及患者的临床状况，建议采取保守治疗，随后患者出院接受进一步随访。每月的常规血管造影显示出血90天后动脉瘤消退，这强烈提示血管夹层形成。
结论
我们强调在SAH的鉴别诊断中需要考虑这些动脉瘤，尤其是当SAH发生在后颅窝且血管造影结果不明确时。
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