Zhang Hui, Feng Lei
Department of Neurosurgery, The First People's Hospital of Jining, Jining, China.
Department of Neurosurgery, The First People's Hospital of Jining, Jining, China.
World Neurosurg. 2018 Apr;112:25-30. doi: 10.1016/j.wneu.2018.01.011. Epub 2018 Jan 8.
Coarctation of the aorta (CoA) complicated with rupture and hemorrhage of intracranial aneurysms is not commonly seen in clinical practice. Here we report a middle-aged female patient who presented with acute severe headache.
Head computed tomography (CT) demonstrated an extensive subarachnoid hemorrhage. Digital subtraction angiography demonstrated coarctation and occlusion of the proximal thoracic aorta and occlusion of the terminal aortic arch. Aortic-intracranial CT angiography (CTA) confirmed a CoA complicated with an anterior communicating artery aneurysm. Clipping of the anterior communicating artery aneurysm was performed via a left lateral orbital approach. Postoperative intracranial CTA showed complete clipping of the aneurysm. The patient was discharged postoperatively with good recovery.
The pathophysiological mechanism of CoA complicated with intracranial aneurysm remains unclear, but attention should be given to the relationship between the 2 entities in clinical practice, and effective treatment should be provided according to specific conditions.
主动脉缩窄（CoA）合并颅内动脉瘤破裂出血在临床实践中并不常见。在此，我们报告一名出现急性剧烈头痛的中年女性患者。
头部计算机断层扫描（CT）显示广泛蛛网膜下腔出血。数字减影血管造影显示胸主动脉近端缩窄并闭塞以及主动脉弓末端闭塞。主动脉 - 颅内CT血管造影（CTA）证实CoA合并前交通动脉瘤。通过左侧眶外侧入路对前交通动脉瘤进行夹闭。术后颅内CTA显示动脉瘤夹闭完全。患者术后恢复良好出院。
CoA合并颅内动脉瘤的病理生理机制尚不清楚，但在临床实践中应关注两者之间的关系，并根据具体情况提供有效治疗。
