Andereggen Lukas, Gruber Philipp, Anon Javier, Tortora Angelo, Steiger Hans-Jakob, Schubert Gerrit A, Marbacher Serge, Remonda Luca
Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.
Faculty of Medicine, University of Bern, Bern, Switzerland.
Front Surg. 2022 Dec 16;9:860416. doi: 10.3389/fsurg.2022.860416. eCollection 2022.
There is no consensus in the treatment strategy of intracranial aneurysms (IAs) associated with brain arteriovenous malformation (BAVM). In particular, it is unknown if a more aggressive approach should be considered in patients harboring a BAVM, in whom multiple aneurysms or a history of aneurysmal subarachnoid hemorrhage (aSAH) is present.
We report on an elderly woman harboring multiple aneurysms with a history of SAH due to rupture of an unrelated IA. On evaluation, she was also found to harbor a contralateral, left parietal convexity BAVM. Following resection of the latter, spontaneous regression of two large flow-related aneurysms was encountered.
We discuss the therapeutic decision-making, risk stratification, and functional outcome in this patient with regard to the pertinent literature on the risk of hemorrhage in IAs associated with BAVM.
对于与脑动静脉畸形（BAVM）相关的颅内动脉瘤（IA）的治疗策略，目前尚无共识。特别是，对于患有BAVM且存在多个动脉瘤或有动脉瘤性蛛网膜下腔出血（aSAH）病史的患者，是否应考虑采取更积极的治疗方法尚不清楚。
我们报告了一名老年女性，她有多个动脉瘤，因无关的IA破裂而有SAH病史。经评估，还发现她对侧左顶叶凸面存在BAVM。在切除后者后，两个与血流相关的大动脉瘤出现了自发消退。
我们结合关于与BAVM相关的IA出血风险的相关文献，讨论了该患者的治疗决策、风险分层及功能结局。
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