Tashiro T, Ikota T, Yamashita K, Kodama T
Department of Neurosurgery, Hokkaido Kin-Ikyo Central Hospital, Sapporo, Japan.
No Shinkei Geka. 1988 Aug;16(9):1073-8.
An unusual case of post-irradiation aneurysm of extracranial internal carotid artery is presented. A 70-year-old man, complaining of left cervical throbbing mass with focal pain, was admitted on February 8, 1985. It was noted, from his past history, that he had had surgery of the removal of cervical lymph-nodes and that unknown dosage of irradiation had been added to the cervical region 30 years before. Left carotid angiography (on admission) demonstrated a giant aneurysm in the cervical portion of internal carotid artery. Right carotid angiography with compression of left carotid artery revealed good cross filling through anterior communicating artery. Computed tomography with contrast media showed a ring like enhanced mass, which was thought to showed a ring like enhanced mass, which was thought to suggest that a large part of the aneurysm was filled with intraluminal thrombosis. During 30 days of evaluation, the aneurysm grew larger and his cervical pain became untolerable. Operation, the resection of the aneurysm and the reconstruction (of circulation) with vein graft, was challenged n March 12. It was so difficult with meticulous work that the ligation of left common carotid artery was performed after all. Seven days after the operation, he suffered from the gastrointestinal bleeding, which was enough to lead him to hypovolemic shock. Thereafter, right hemiparesis and aphasia were brought about. Two months later, he die of pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)
本文报告一例罕见的颅外颈内动脉放疗后动脉瘤病例。一名70岁男性，因左侧颈部搏动性肿块伴局部疼痛于1985年2月8日入院。从其既往病史可知，他曾接受过颈部淋巴结切除术，30年前颈部曾接受过剂量不详的放疗。左侧颈动脉血管造影（入院时）显示颈内动脉颈部有一个巨大动脉瘤。压迫左侧颈动脉进行右侧颈动脉血管造影显示通过前交通动脉有良好的交叉充盈。增强计算机断层扫描显示一个环形强化肿块，认为提示动脉瘤的大部分腔内有血栓形成。在评估的30天内，动脉瘤增大，颈部疼痛变得难以忍受。3月12日尝试进行手术，切除动脉瘤并用静脉移植物重建（循环）。手术非常困难，经过精细操作后最终还是结扎了左侧颈总动脉。术后7天，他出现胃肠道出血，足以导致他发生低血容量性休克。此后，出现右侧偏瘫和失语。两个月后，他死于肺炎。（摘要截取自250字）
