Hou Kun, Xu Kan, Liu Hongping, Li Guichen, Yu Jinlu
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China.
Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2020 Oct 27;11:564797. doi: 10.3389/fneur.2020.564797. eCollection 2020.
As a result of their low incidence, most of the studies on intracranial aneurysms associated with middle cerebral artery (MCA) anomalies were presented as case reports or small case series. No systematic review on this specific entity has been conducted. A PubMed search of the published studies was performed on April 6th, 2019 for patients who had intracranial aneurysms associated with MCA anomalies. The languages included in this study were English, Chinese, and Japanese. Finally, 58 articles reporting of 67 patients including 1 case in our center were included. The identified patients (37 females, 55.2%) aged from 4 to 81 (49.85 ± 15.22) years old. 50 (50/67, 74.6%) patients presented with hemorrhagic stroke either from the MCA anomalies associated aneurysms or other sources. 63 aneurysms (63/67, 94.0%) were saccular, 3 (4.5%) were dissecting or fusiform, and 1 (1.5%) was pseudoaneurysm. 32 (32/65, 49.2%) patients had other concurrent cerebrovascular anomalies. 56 (83.6%) patients underwent open surgeries, 8 (11.9%) patients underwent endovascular treatment, and 3 (4.5%) patients were conservatively managed. 56 (56/61, 91.8%) patients achieved a good recovery. The pathophysiological genesis of intracranial aneurysms associated with MCA anomalies is still obscure. The inflicted patients tend to have other concurrent cerebrovascular anomalies, which denotes that congenital defect in cerebrovascular development might play a role in this process. Most of the affected patients could experience a good recovery after treatment.
由于颅内动脉瘤合并大脑中动脉（MCA）异常的发病率较低，大多数相关研究都以病例报告或小病例系列的形式呈现。目前尚未对这一特定实体进行系统综述。2019年4月6日，我们在PubMed上检索了已发表的关于颅内动脉瘤合并MCA异常患者的研究。本研究纳入的语言包括英语、中文和日语。最终，共纳入58篇报道67例患者的文章，其中包括我们中心的1例。确诊患者年龄在4至81岁之间（49.85±15.22），其中女性37例（55.2%）。50例（50/67，74.6%）患者出现出血性卒中，原因是MCA异常相关动脉瘤破裂或其他原因。63个动脉瘤（63/67，94.0%）为囊状，3个（4.5%）为夹层或梭形，1个（1.5%）为假性动脉瘤。32例（32/65，49.2%）患者合并其他脑血管异常。56例（83.6%）患者接受了开颅手术，8例（11.9%）患者接受了血管内治疗，3例（4.5%）患者接受了保守治疗。56例（56/61，91.8%）患者恢复良好。颅内动脉瘤合并MCA异常的病理生理发生机制仍不清楚。受累患者往往合并其他脑血管异常，这表明脑血管发育的先天性缺陷可能在此过程中起作用。大多数患者经治疗后可恢复良好。
