Zhou Long, Ren Yuting, Li Zhiyang, Zhang Huikai, Wei Hangyu, Song Ping, Cheng Li, Wang Wenju, Gao Lun, Lei Pan, Hua Qiuwei, Chen Qianxue, Zhou Jinjian, Li Guoliang, Cai Qiang
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430223, China.
Department of Neurosurgery, Hubei Yunmeng County Hospital of Traditional Chinese Medicine, Yunmeng, Hubei 432500, China.
Heliyon. 2023 May 18;9(6):e16193. doi: 10.1016/j.heliyon.2023.e16193. eCollection 2023 Jun.
Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. 3D Slicer reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.
We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used 3D Slicer reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.
Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and 3D Slicer reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
单纯性脑室出血常继发于烟雾病,很少由脑室内动脉瘤破裂引起。后者的手术治疗极具挑战性。三维(3D)切片器重建技术可精确定位颅内小病变,与经颅神经内镜微创手术相结合是治疗上述疾病的新尝试。
我们报告一例因脉络膜前动脉远段动脉瘤破裂继发的单纯性脑室内出血病例。入院前脑部计算机断层扫描(CT)显示为单纯性脑室出血,术前脑部CT血管造影(CTA)显示脉络膜前动脉远段动脉瘤。我们在手术前使用3D切片器进行重建并精确确定病灶位置,采用经颅神经内镜微创手术技术完全清除脑室内血肿,并发现责任动脉瘤位于脑室内。
单纯性脑室内出血需警惕脉络膜前动脉远段动脉瘤。目前,传统的显微开颅手术和血管内介入治疗存在局限性,3D切片器重建及精确定位技术联合经颅神经内镜微创手术可能是一种不错的选择。