Sato K, Fujiwara S, Yoshimoto T, Suzuki J, Onuma T
Division of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan.
No Shinkei Geka. 1988 Feb;16(2):211-5.
Although spontaneous thrombosis of a giant intracranial aneurysm is comparatively common, its parent artery occlusion is rare. Recently we experienced two cases in which spontaneous thrombosis of giant intracranial internal carotid artery aneurysm and occlusion of its parent artery were occurred. Case 1. A 49-year-old man, complaining esotropia was referred to us by an ophthalmologist. He had no particular past history. Neurological examination revealed left oculomotor, abducens palsy and disturbance of left trigeminal first branch. CT scan revealed a round high density mass in the left middle fossa. The size was 3 cm in diameter. Left CAG revealed severe stenosis of left internal carotid artery and in delayed phase, faint shadow was seen near posterior clinoid process. MRI revealed a high intensity mass of the intraaneurysmal thrombus in the left middle fossa with small low intensity area indicating residual lumen. With conservative treatment, the symptom was gradually improved and one month after admission, complete occlusion of the left internal carotid artery was seen by angiography. The patient returned to his previous occupation. Case 2. A 21-year-old man was admitted to our hospital complaining dysarthria and left hemiparesis. He had been diagnosed as left internal carotid giant aneurysm 5 years before when he had suffered from right visual disturbance. Neurological examination revealed left hemiparesis and dysarthria. CT scan revealed high density mass which extended from the base of the right middle fossa to the third ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
虽然巨大颅内动脉瘤的自发性血栓形成相对常见,但其供血动脉闭塞却很罕见。最近我们遇到了两例巨大颅内颈内动脉瘤自发性血栓形成并伴有其供血动脉闭塞的病例。病例1. 一名49岁男性,因内斜视被眼科医生转诊至我院。他无特殊既往史。神经系统检查发现左侧动眼神经、展神经麻痹以及左侧三叉神经第一支功能障碍。CT扫描显示左侧中颅窝有一圆形高密度肿块,直径3厘米。左侧脑血管造影(CAG)显示左侧颈内动脉严重狭窄,延迟期可见后床突附近有模糊阴影。MRI显示左侧中颅窝动脉瘤内血栓呈高信号肿块,有小的低信号区提示残留管腔。经保守治疗,症状逐渐改善,入院1个月后血管造影显示左侧颈内动脉完全闭塞。患者恢复了之前的工作。病例2. 一名21岁男性因构音障碍和左侧偏瘫入院。5年前他因右侧视力障碍被诊断为左侧颈内动脉巨大动脉瘤。神经系统检查发现左侧偏瘫和构音障碍。CT扫描显示高密度肿块从右侧中颅窝底部延伸至第三脑室。(摘要截取自250字)