Coxon Andrew T, Huguenard Anna L, Chatterjee Arindam R, Dacey Ralph G
Departments of1Neurosurgery.
2Radiology, and.
J Neurosurg Case Lessons. 2023 Feb 13;5(7). doi: 10.3171/CASE22497.
Intracranial fusiform aneurysms are circumferential dilations of cerebral arteries that can lead to complications including ischemic stroke due to vessel occlusion, subarachnoid hemorrhage, or intracerebral hemorrhage. Treatment options for fusiform aneurysms have expanded significantly in recent years. Microsurgical treatment options include proximal and distal surgical occlusion and microsurgical trapping of the aneurysm, usually in association with high-flow bypass procedures. Endovascular treatment options include the placement of coils and/or flow diverters.
Here the authors report a case of aggressive surveillance and treatment of a man with multiple progressive, recurrent, and de novo fusiform aneurysms of the left anterior cerebral circulation over 16 years. Because the long-term course of his treatment coincided with the recent expansion of endovascular treatment options, he underwent every type of treatment listed above.
This case demonstrates the wide range of therapeutic options for fusiform aneurysms and how the treatment model for these lesions has evolved.
颅内梭形动脉瘤是脑动脉的环形扩张，可导致多种并发症，包括因血管闭塞引起的缺血性卒中、蛛网膜下腔出血或脑出血。近年来，梭形动脉瘤的治疗选择有了显著扩展。显微外科治疗选择包括近端和远端手术夹闭以及动脉瘤的显微外科包裹术，通常与高流量搭桥手术联合进行。血管内治疗选择包括置入弹簧圈和/或血流导向装置。
本文作者报告了一例对一名患有多发性进行性、复发性和新生性左前脑循环梭形动脉瘤的男性患者进行积极监测和治疗达16年的病例。由于其长期治疗过程与血管内治疗选择的近期扩展相吻合，他接受了上述每种治疗。
该病例展示了梭形动脉瘤广泛的治疗选择以及这些病变的治疗模式是如何演变的。
