Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, China.
Curr Med Imaging. 2022;18(4):429-431. doi: 10.2174/1573405617666210924154946.
Clinically, the recurrent artery of the Heubner (RAH) aneurysm is extremely rare, commonly presents with subarachnoid hemorrhage (SAH).
A 73-year-old man with a known moyamoya disease was presented as caudate hemorrhage attributable to an incidental flow aneurysm distal on the right RAH, which was managed conservatively after an unsuccessful endovascular attempt. Unfortunately, the patient died five weeks after hospital discharge because of the re-rupture of the aneurysm. To the best of our knowledge, the RAH aneurysm manifesting as caudate hemorrhage without SAH has not previously been reported.
This case highlights that the RAH aneurysm masquerading as caudate hemorrhage without SAH is exceedingly rare but can be encountered, representing a diagnostic and therapeutic challenge, and should be considered in the differential diagnosis. Moreover, early identifying and then eliminating such vascular anomaly if possible is of importance to prevent fatal hemorrhage.
临床上，Heubner 动脉（RAH）动脉瘤极为罕见，通常表现为蛛网膜下腔出血（SAH）。
一名 73 岁男性患有已知的烟雾病，因右侧 RAH 远端的偶然血流动脉瘤引起尾状核出血，血管内尝试失败后采用保守治疗。不幸的是，患者在出院后五周因动脉瘤再次破裂而死亡。据我们所知，没有报道过 RAH 动脉瘤表现为无 SAH 的尾状核出血。
本病例强调了以无 SAH 的尾状核出血为表现的 RAH 动脉瘤极为罕见但可能存在，这代表了诊断和治疗的挑战，应在鉴别诊断中考虑。此外，如果可能，早期识别并消除这种血管异常对于预防致命性出血很重要。
