Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.
World Neurosurg. 2019 Sep;129:526-530.e1. doi: 10.1016/j.wneu.2019.04.245. Epub 2019 May 8.
Spontaneous thrombosis of an intracranial aneurysm is rare but is common in fusiform or large cystic aneurysms, which result in subarachnoid hemorrhage after rupture. This case reports a 47-year-old woman with subarachnoid hemorrhage who developed spontaneous thrombosis of an aneurysm due to rupture of the posterior inferior cerebellar aneurysm.
The patient was admitted to the hospital with history of sudden headache and vomiting for 3 days. According to early imaging findings, she was initially diagnosed as having a cavernous hemangioma with hemorrhage in the left cerebellum, but according to the intraoperative pictures and postoperative pathologic results, the diagnosis was an aneurysm with thrombosis.
This case represents a rare but important complication of ruptured intracranial aneurysm, which can be easily misdiagnosed or ignored. It should be given great attention and considered in patients with subarachnoid hemorrhage who are negative for imaging examinations.
颅内动脉瘤自发性血栓形成较为罕见,但在梭形或大囊性动脉瘤中较为常见,破裂后可导致蛛网膜下腔出血。本病例报告了一例因后下小脑动脉瘤破裂导致蛛网膜下腔出血的 47 岁女性患者,其颅内动脉瘤自发性血栓形成。
患者因突发头痛和呕吐 3 天入院。根据早期影像学检查结果,患者最初被诊断为左侧小脑海绵状血管瘤伴出血,但根据术中图片和术后病理结果,诊断为动脉瘤伴血栓形成。
该病例代表了破裂颅内动脉瘤的一种罕见但重要的并发症,易被误诊或忽视。对于影像学检查阴性的蛛网膜下腔出血患者,应高度重视并考虑该并发症。