Hamm K D, Pothe H, Steube D, Kachel R, Beleites E
Abteilung Neurochirurgie, Medizinischen Akademie Erfurt.
Neurochirurgia (Stuttg). 1988 May;31(3):88-92. doi: 10.1055/s-2008-1053908.
Traumatic infraclinoidal aneurysms of the internal carotid artery are rare. They can occur after craniocerebral lesions and can lead to life-threatening haemorrhages from the nasopharyngeal space. Frequently it may take months after the accident before the patient experiences single or repeated rupture bleeding and is referred to acute treatment in an ENT ward. Angiography can confirm the diagnosis and is mandatory to clarify the question of collateral flow in cerebral circulation. In case of local inoperability combined with the need for a ligature of the internal carotid artery, the protective application of an extra-intracranial microvascular anastomosis is an improved safeguard against postoperative deficits. During the past five years five patients suffering from an infraclinoidal aneurysm of the carotid artery have been operated on successfully in this manner. Two of these patients suffered from a traumatic aneurysm; these two case reports are presented.
颈内动脉创伤性鞍下动脉瘤罕见。它们可发生于颅脑损伤后,可导致鼻咽部危及生命的出血。事故发生后,患者通常要数月后才会出现单次或反复破裂出血,并被转诊至耳鼻喉科病房进行急症治疗。血管造影可确诊,对于明确脑循环侧支血流问题必不可少。若局部无法手术且需要结扎颈内动脉,应用颅外微血管吻合术进行保护可更好地预防术后功能缺损。在过去五年中,五例患有颈动脉鞍下动脉瘤的患者已通过这种方式成功手术。其中两名患者患有创伤性动脉瘤;现将这两例病例报告如下。