Nomura Motohiro, Mori Kentaro, Fukui Issei, Yanagimoto Kunio, Shima Hiroshi, Muramatsu Naoki
1 Department of Neurosurgery, Kanto Rosai Hospital, Kawasaki, Japan.
2 Department of Neurosurgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
Neuroradiol J. 2018 Jun;31(3):317-319. doi: 10.1177/1971400917741904. Epub 2017 Nov 10.
A 20-year-old man presented with consciousness disturbance and hemiparesis, and computed tomography demonstrated subarachnoid and intracerebral hemorrhage. Angiography on admission demonstrated a slight irregularity of the middle cerebral artery (MCA) branch. Angiography on the 12th day showed a suspicious lesion at M3 of the left MCA. Angiography performed 24 days after the onset disclosed an aneurysm at M3. The aneurysm was trapped and resected after superficial temporal artery-MCA bypass. Pathological examinations revealed that this distal aneurysm was a pseudoaneurysm without vascular components in its dome. Although a lesion that may cause subarachnoid or intracerebral hemorrhage was not detected on the initial angiography, repeated examinations revealed the atypical vascular lesion in distal MCA.
一名20岁男性出现意识障碍和偏瘫，计算机断层扫描显示蛛网膜下腔和脑内出血。入院时血管造影显示大脑中动脉（MCA）分支有轻微不规则。第12天的血管造影显示左MCA的M3处有可疑病变。发病24天后进行的血管造影显示M3处有一个动脉瘤。在颞浅动脉-MCA搭桥术后，该动脉瘤被夹闭并切除。病理检查显示，这个远端动脉瘤是一个假性动脉瘤，其瘤顶没有血管成分。尽管在最初的血管造影中未检测到可能导致蛛网膜下腔或脑内出血的病变，但反复检查发现了远端MCA的非典型血管病变。
