Nimjee Shahid M, Smith Tony P, Kanter Ronald J, Ames Warwick, Machovec Kelly A, Grant Gerald A, Zomorodi Ali R
Departments of 1 Radiology and.
Divisions of 2 Neurosurgery and.
J Neurosurg Pediatr. 2015 Jun;15(6):625-9. doi: 10.3171/2014.11.PEDS14290. Epub 2015 Mar 6.
Large cerebral aneurysms of the basilar apex are difficult to treat. Recently, endovascular treatment has mitigated much of the morbidity associated with treating these lesions. However, the morphology of aneurysms of the vertebrobasilar system can preclude endovascular treatment. Rapid ventricular pacing (RVP) facilitates open surgical treatment of cerebral aneurysms. It can assist in reducing the pressure of the neck of the aneurysm, allowing safe application of a clip. The authors present a case of a pediatric patient who developed a basilar artery pseudoaneurysm that required surgery. Given the large size of the aneurysm, RVP was performed, allowing the surgeons to dissect the dome of the aneurysm from the surrounding tissue and pontine perforating branches away from the lesion to safely clip the lesion. The patient had an uneventful recovery. To the authors' knowledge, this represents the first known case of RVP to aid in basilar artery clip occlusion in a pediatric patient.
基底动脉尖大型脑动脉瘤难以治疗。近年来，血管内治疗已减轻了与治疗这些病变相关的许多发病率。然而，椎基底动脉系统动脉瘤的形态可能使血管内治疗无法进行。快速心室起搏（RVP）有助于脑动脉瘤的开放手术治疗。它可以帮助降低动脉瘤颈部的压力，使夹子能够安全应用。作者报告了一例患有基底动脉假性动脉瘤需要手术的儿科患者。鉴于动脉瘤体积较大，进行了快速心室起搏，使外科医生能够将动脉瘤的瘤顶与周围组织以及脑桥穿支从病变处分离，从而安全地夹闭病变。患者恢复顺利。据作者所知，这是已知的第一例快速心室起搏辅助儿科患者夹闭基底动脉的病例。
