大脑中动脉瘤破裂致脑内血肿形成假性动脉瘤
Pseudoaneurysm Formation in Intracerebral Hematoma due to Ruptured Middle Cerebral Artery Aneurysm.
作者信息
Nomura Motohiro, Tamase Akira, Kamide Tomoya, Mori Kentaro, Seki Syunsuke, Yanagimoto Kunio
机构信息
Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Sakae-ku, Yokohama, Japan.
Department of Pathology, Yokohama Sakae Kyosai Hospital, Sakae-ku, Yokohama, Japan.
出版信息
Surg J (N Y). 2015 Nov 19;1(1):e47-e49. doi: 10.1055/s-0035-1567877. eCollection 2015 Dec.
We report the case of a ruptured middle cerebral artery aneurysm that showed pseudoaneurysm formation in an intracerebral hematoma. A 61-year-old man who was taking warfarin complained of dysarthria. Three days later, he was found unconscious, and computed tomography on admission showed subarachnoid hemorrhage and an intracerebral hematoma in the left temporal lobe. Three-dimensional computed tomographic angiography showed an irregular-shaped aneurysm-like cavity extending from the left middle cerebral artery into the hematoma. Intraoperative observation revealed that the aneurysm itself was small and the lesion observed on computed tomography was a pseudoaneurysm that had formed in the hematoma. Pathologic examination of the aneurysm demonstrated that there was a thrombus at its tip. In this report, radiologic characteristics of three-dimensional computed tomographic angiography and etiology of a pseudoaneurysm in an intracerebral hematoma due to aneurysm rupture are discussed.
我们报告一例大脑中动脉动脉瘤破裂病例，该病例显示脑内血肿形成假性动脉瘤。一名正在服用华法林的61岁男性主诉构音障碍。三天后，他被发现昏迷，入院时的计算机断层扫描显示蛛网膜下腔出血和左颞叶脑内血肿。三维计算机断层血管造影显示一个不规则形状的动脉瘤样腔隙从左大脑中动脉延伸至血肿内。术中观察发现动脉瘤本身较小，计算机断层扫描上观察到的病变是血肿内形成的假性动脉瘤。动脉瘤的病理检查显示其尖端有血栓形成。在本报告中，讨论了三维计算机断层血管造影的影像学特征以及动脉瘤破裂导致脑内血肿形成假性动脉瘤的病因。
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