Herath Hmmtb, Yogendranathan Nilukshana, Kulatunga Aruna
The National Hospital of Sri Lanka, Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2019 Apr 4;7:2050313X19841151. doi: 10.1177/2050313X19841151. eCollection 2019.
Neurofibromatosis is a neurocutaneous genetic condition with dysplasia of the mesodermal and ectodermal tissues. Vascular abnormalities are well recognized in neurofibromatosis and cerebral aneurysms are rarely reported in literature. Here, we present a 20-year-old Sri Lankan female presented with headache, altered personality, disinhibited behaviour, and urinary incontinence. On imaging, she was found to have infarctions of both frontal lobes and evidence of a ruptured anterior communicating artery aneurysm with a small subarachnoid haemorrhage. Another small middle cerebral artery aneurysm was also seen in the angiogram. She was managed conservatively and gradually recovered. Because aneurysms in neurofibromatosis are usually asymptomatic and as rupture of such an aneurysm is rare, regular vascular screening is not recommended to all patients with neurofibromatosis. This is the first case report in literature in which a patient with neurofibromatosis presented with infarctions of both frontal lobes due to rupture of an anterior communicating artery aneurysm.
神经纤维瘤病是一种神经皮肤遗传性疾病，伴有中胚层和外胚层组织发育异常。神经纤维瘤病中的血管异常已得到充分认识，而脑动脉瘤在文献中鲜有报道。在此，我们报告一名20岁的斯里兰卡女性，她出现头痛、性格改变、行为抑制解除和尿失禁症状。影像学检查发现她双侧额叶梗死，并有前交通动脉动脉瘤破裂伴少量蛛网膜下腔出血的证据。血管造影还发现了另一处小的大脑中动脉动脉瘤。她接受了保守治疗并逐渐康复。由于神经纤维瘤病中的动脉瘤通常无症状，且此类动脉瘤破裂罕见，因此不建议对所有神经纤维瘤病患者进行常规血管筛查。这是文献中首例神经纤维瘤病患者因前交通动脉动脉瘤破裂出现双侧额叶梗死的病例报告。
