儿童烟雾病表现为破裂的大脑前动脉动脉瘤引起的蛛网膜下腔出血。
Pediatric Moyamoya Presenting as a Subarachnoid Hemorrhage from a Ruptured Anterior Cerebral Artery Aneurysm.
机构信息
Department of Neurosurgery, Johns Hopkins University School of Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Saint Petersburg, Florida, USA.
Division of Neurosurgery, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon.
出版信息
World Neurosurg. 2020 Feb;134:123-127. doi: 10.1016/j.wneu.2019.10.157. Epub 2019 Nov 2.
BACKGROUND
The incidence of Moyamoya disease (MMD)-associated intracranial aneurysms ranges from 3% to 14% in adult patients, whereas this complication has rarely been reported in children.
CASE DESCRIPTION
We herein report the first case, to our knowledge, of an extremely rare subarachnoid hemorrhage presentation of a child with a ruptured anterior cerebral artery dissecting aneurysm secondary to a newly discovered, unilateral Moyamoya-like pathology.
CONCLUSIONS
MMD-associated aneurysms are extremely rare in children, and hemorrhage may be the initial presentation of the disease. Prompt intervention is essential to exclude the ruptured aneurysm that is at risk of rebleeding because of persistent hemodynamic stress.
背景
成人烟雾病患者颅内动脉瘤的发病率为 3%至 14%，而在儿童中，这种并发症很少见。
病例描述
我们在此报告首例已知病例，一名儿童因新发现的单侧烟雾病样病变导致大脑前动脉夹层动脉瘤破裂，出现极为罕见的蛛网膜下腔出血。
结论
儿童烟雾病相关性动脉瘤极为罕见，出血可能是该病的首发表现。由于持续的血流动力学压力，存在破裂风险的动脉瘤有再出血的危险，因此及时干预至关重要。
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