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小脑下前动脉动脉瘤:各节段及手术和血管内治疗结果

Anterior inferior cerebellar artery aneurysms: Segments and results of surgical and endovascular managements.

作者信息

Lv Xianli, Ge Huijian, He Hongwei, Jiang Chuhan, Li Youxiang

机构信息

Interventional Neuroradiology Department, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Interventional Neuroradiology Department, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China

出版信息

Interv Neuroradiol. 2016 Dec;22(6):643-648. doi: 10.1177/1591019916656474. Epub 2016 Aug 2.

Abstract

BACKGROUND

Anterior inferior cerebellar artery (AICA) aneurysms are rare and published clinical experience with these aneurysms is limited.

OBJECTIVE

The objective of this article is to report angiographic characteristics and results associated with premeatal, meatal and postmeatal segments, surgical and endovascular therapies.

METHODS

A literature review was performed through PubMed using "anterior inferior cerebellar artery aneurysm" through January 2016. Clinical data, angiograms, management techniques, and patient outcomes were reviewed for 47 collected cases in 30 previous reports.

RESULTS

Of these aneurysms, 21 (44.7%) were associated with meatal segment, 10 (21.3%) were postmeatal and 16 (34.0%) were premeatal. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy (77.8%). Patient outcomes of meatal aneurysms presented with more neuropathies (51.7%) and cerebellar symptoms (14.3%) (p = 0.049). Four cases of meatal aneurysm with preoperative cranial nerve deficits (two VII and two VIII) showed improvement after surgery. Endovascular treatment achieved outcomes similar to surgical treatment (p = 0.327).

CONCLUSIONS

AICA aneurysms have a predilection for meatal segment. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy. Patient outcomes of meatal aneurysms presented with more neuropathies and cerebellar symptoms. Endovascular treatment achieved outcomes similar to surgical treatment.

摘要

背景

小脑前下动脉(AICA)动脉瘤较为罕见,关于这些动脉瘤的已发表临床经验有限。

目的

本文的目的是报告与穿髓段、髓内段和髓后段相关的血管造影特征及结果,以及手术和血管内治疗情况。

方法

通过PubMed对截至2016年1月使用“小脑前下动脉动脉瘤”进行文献检索。回顾了之前30篇报告中47例收集病例的临床资料、血管造影片、治疗技术及患者预后。

结果

在这些动脉瘤中,21例(44.7%)与髓内段相关,10例(21.3%)为髓后段,16例(34.0%)为穿髓段。髓内动脉瘤患者更易出现蛛网膜下腔出血、听力丧失及面瘫(77.8%)。髓内动脉瘤患者的预后出现更多神经病变(51.7%)和小脑症状(14.3%)(p = 0.049)。4例术前存在颅神经缺损(2例VII和2例VIII)的髓内动脉瘤患者术后症状改善。血管内治疗取得了与手术治疗相似的结果(p = 0.327)。

结论

AICA动脉瘤好发于髓内段。髓内动脉瘤患者更易出现蛛网膜下腔出血、听力丧失及面瘫。髓内动脉瘤患者的预后出现更多神经病变和小脑症状。血管内治疗取得了与手术治疗相似的结果。

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本文引用的文献

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Ruptured Total Intrameatal Anterior Inferior Cerebellar Artery Aneurysm.破裂的全内听道小脑前下动脉动脉瘤
J Korean Neurosurg Soc. 2015 Aug;58(2):141-3. doi: 10.3340/jkns.2015.58.2.141. Epub 2015 Aug 28.
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Formation of a pseudoaneurysm in the chronic phase at the site of a ruptured dissecting anterior inferior cerebellar artery aneurysm.
Acta Neurochir (Wien). 2015 Jun;157(6):1045-7. doi: 10.1007/s00701-015-2397-5. Epub 2015 Apr 19.
4
Endovascular treatment for ruptured distal anterior inferior cerebellar artery aneurysm.小脑前下动脉远端破裂动脉瘤的血管内治疗
J Cerebrovasc Endovasc Neurosurg. 2014 Mar;16(1):20-5. doi: 10.7461/jcen.2014.16.1.20. Epub 2014 Mar 31.

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