Xu Kan, Hou Kun, Xu Baofeng, Guo Yunbao, Yu Jinlu
The First Hospital of Jilin University, Neurosurgery, Changchun, Jilin, China.
J Neurol Surg A Cent Eur Neurosurg. 2020 May;81(3):271-278. doi: 10.1055/s-0039-1698381. Epub 2020 Jan 21.
The occurrence of multiple intracranial aneurysms (MIAs) is not rare, with a reported incidence of 15 to 35%. However, patients harboring seven or more intracranial aneurysms are so uncommon that only sporadic cases have ever been reported. We present a rare case with seven intracranial aneurysms (two anterior communicating artery aneurysms, two right middle cerebral artery aneurysms, two left ophthalmic artery aneurysms, and one right ophthalmic artery aneurysm) in the anterior circulation that were simultaneously clipped via the extended right pterional approach. The surgery was uneventful. The patient experienced a rapid postoperative recovery with no neurologic deficits. To our knowledge, this is the first case of seven bilateral intracranial aneurysms that were surgically clipped via unilateral craniotomy. This case showed that in properly selected patients with anterior circulation MIAs, even as many as seven, one-stage clipping can be achieved. Successful clipping of the contralateral ophthalmic aneurysms was the key step in the operation.
多发性颅内动脉瘤（MIAs）的发生并不罕见，报道的发病率为15%至35%。然而，患有七个或更多颅内动脉瘤的患者非常罕见，仅有散发病例的报道。我们报告一例罕见病例，在前循环中有七个颅内动脉瘤（两个前交通动脉动脉瘤、两个右侧大脑中动脉动脉瘤、两个左侧眼动脉动脉瘤和一个右侧眼动脉动脉瘤），通过扩大的右侧翼点入路同时进行夹闭。手术过程顺利。患者术后恢复迅速，无神经功能缺损。据我们所知，这是首例通过单侧开颅手术夹闭七个双侧颅内动脉瘤的病例。该病例表明，在适当选择的前循环MIAs患者中，即使多达七个动脉瘤，也可以进行一期夹闭。成功夹闭对侧眼动脉瘤是手术的关键步骤。
