Oba M, Suzuki M, Onuma T
Department of Neurosurgery, Sendai City Hospital, Japan.
No Shinkei Geka. 1989 Apr;17(4):365-8.
Two rare cases of fusiform aneurysms of A1 segment of the anterior cerebral artery are reported. Case 1: A 62-year-old woman was admitted with sudden onset of severe headache and loss of consciousness, on August 22, 1982. CT scan showed subarachnoid hemorrhage at the basal cisterns. Left carotid angiography revealed a spindle shaped aneurysmal dilatation in the A1 segment of the anterior cerebral artery. Four-vessel angiography was performed twice but no other aneurysm was found. She was treated conservatively and the clinical course was not eventful. She was discharged with no neurological deficit one month after the admission. Case 2: A 49-year-old man complained of sudden onset of severe headache, nausea and vomiting on August 24, 1986. He was transferred to a local hospital and CT scan showed subarachnoid hemorrhage at the basal cisterns. Angiography revealed a fusiform aneurysm of the proximal anterior cerebral artery. He was referred to our hospital on the day of onset. He was operated on via bifrontal interhemispheric approach. The fusiform aneurysm of A1 segment was trapped successfully using temporary occlusion of A1 and A2 bilaterally under the administration of Sendai-Cocktail. V-P shunt was performed 1 week after the aneurysmal operation. The post-operative course was uneventful. He was discharged with no neurological deficit three months after operation. As far as we know, there are 6 cases of fusiform aneurysm of A1 segment of anterior cerebral artery in the literature. In this report, our two cases were described and treatment of such aneurysms were discussed.
本文报告了两例大脑前动脉A1段梭形动脉瘤的罕见病例。病例1：一名62岁女性于1982年8月22日因突发剧烈头痛和意识丧失入院。CT扫描显示基底池蛛网膜下腔出血。左侧颈动脉血管造影显示大脑前动脉A1段呈纺锤形动脉瘤样扩张。进行了两次四血管造影，但未发现其他动脉瘤。对其进行了保守治疗，临床过程平稳。入院一个月后出院，无神经功能缺损。病例2：一名49岁男性于1986年8月24日主诉突发剧烈头痛、恶心和呕吐。他被转至当地医院，CT扫描显示基底池蛛网膜下腔出血。血管造影显示大脑前动脉近端梭形动脉瘤。发病当天他被转诊至我院。通过双额间大脑半球间入路进行手术。在使用仙台混合液的情况下，通过双侧临时阻断A1和A2成功夹闭了A1段的梭形动脉瘤。动脉瘤手术后1周进行了脑室-腹腔分流术。术后过程平稳。术后三个月出院，无神经功能缺损。据我们所知，文献中报道了6例大脑前动脉A1段梭形动脉瘤。在本报告中，描述了我们的两例病例，并讨论了此类动脉瘤的治疗方法。
