Haraguchi Wataru, Kawahara Ichiro, Matsuo Ayaka, Moritsuka Tomoya, Honda Kazuya, Ito Takehiro, Hiu Takeshi, Ono Tomonori, Ushijima Ryujiro, Tsutsumi Keisuke
Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center.
No Shinkei Geka. 2020 Oct;48(10):949-955. doi: 10.11477/mf.1436204301.
Cerebral aneurysms and arachnoid cysts are relatively common cerebral malformations and the use of recent modalities has increased their detection rates. However, cerebral aneurysms associated with arachnoid cysts are unusual. We describe two cases of ruptured cerebral aneurysms associated with arachnoid cysts. According to previous reports, clinical presentation may sometimes be unusual, as cysts can prevent subarachnoid hemorrhage. Moreover, in some cases, CT may reveal typical arachnoid cysts without subarachnoid hemorrhage, without intracystic hematoma, or with subdural hematoma alone. These clinical presentations and radiologic findings can lead to delayed diagnosis of subarachnoid hemorrhage. Therefore, we should consider the coexistence of arachnoid cyst in case of a warning sign of aneurysm rupture.
脑动脉瘤和蛛网膜囊肿是相对常见的脑畸形,而近年来各种检查手段的应用提高了它们的检出率。然而,与蛛网膜囊肿相关的脑动脉瘤并不常见。我们描述了两例与蛛网膜囊肿相关的破裂脑动脉瘤病例。根据既往报道,临床表现有时可能不典型,因为囊肿可阻止蛛网膜下腔出血。此外,在某些情况下,CT可能显示典型的蛛网膜囊肿,无蛛网膜下腔出血、无囊内血肿或仅有硬膜下血肿。这些临床表现和影像学表现可能导致蛛网膜下腔出血的诊断延迟。因此,在出现动脉瘤破裂的警示征象时,我们应考虑蛛网膜囊肿并存的情况。