Zheng Jian, Li Shu, Cao Yong, Wang Shuo, Wang Rong, Zhao Jizong
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
J Stroke Cerebrovasc Dis. 2015 Jan;24(1):232-8. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.017. Epub 2014 Nov 12.
Multiple cerebral aneurysms resulting from cardiac myxoma is a very rare disease, and the optimal treatment is not yet determined. We present 2 cases of multiple cerebral myxomatous aneurysms and give an overview of the English literature pertaining to this disease.
We described 2 new cases of multiple cerebral myxomatous aneurysms and performed a search of English literature in PubMed and Google Scholar. Keywords used were as follows (single word or combination): "neoplastic aneurysm," "oncotic aneurysm," "aneurysm," and "myxoma." Only patients with multiple cerebral aneurysms resulting from cardiac myxoma and contained adequate follow-up information pertinent to the analysis were included.
One patient underwent craniotomy for resection of an aneurysm. Microscopic examination demonstrated the myxoma in the aneurysmal wall. The other patient was managed conservatively. Thirty-five cases meeting the previously mentioned criteria were found in the literature. This disease was typically diagnosed in young adults (median age = 38 years). Females were more frequently affected (F/M ratio, 2.7:1). A total of 78.4% were managed conservatively. A total of 16.2% underwent craniotomy for aneurysm resection and/or hematoma evacuation. At follow-up, 64.9% were stable, 10.8% revealed disappearance of aneurysms, 10.8% showed enlargement of aneurysms, and the mortality rate was 13.5%.
Patients with multiple cerebral aneurysms should routinely be evaluated for cardiac myxoma and vice versa. Conservative treatment is recommended for most of the patients. Prognosis is good in most patients.
心脏黏液瘤导致的多发性脑动脉瘤是一种非常罕见的疾病，目前尚未确定最佳治疗方案。我们报告2例多发性脑黏液瘤性动脉瘤病例，并对有关该疾病的英文文献进行综述。
我们描述了2例新的多发性脑黏液瘤性动脉瘤病例，并在PubMed和谷歌学术上搜索英文文献。使用的关键词如下（单个词或组合）：“肿瘤性动脉瘤”、“肿胀性动脉瘤”、“动脉瘤”和“黏液瘤”。仅纳入因心脏黏液瘤导致多发性脑动脉瘤且包含与分析相关的充分随访信息的患者。
1例患者接受开颅手术切除动脉瘤。显微镜检查显示动脉瘤壁中有黏液瘤。另1例患者接受保守治疗。文献中发现35例符合上述标准的病例。该疾病通常在年轻人中诊断（中位年龄 = 38岁）。女性更易受累（女性/男性比例为2.7:1）。共有78.4%的患者接受保守治疗。共有16.2%的患者接受开颅手术切除动脉瘤和/或清除血肿。随访时，64.9%的患者病情稳定，10.8%的患者动脉瘤消失，10.8%的患者动脉瘤增大，死亡率为13.5%。
多发性脑动脉瘤患者应常规评估是否存在心脏黏液瘤，反之亦然。建议大多数患者采用保守治疗。大多数患者预后良好。
