Huang Kaixin, Wang Lesheng, Chen Jincao
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Int J Neurosci. 2024 Oct;134(10):1068-1074. doi: 10.1080/00207454.2023.2211729. Epub 2023 Jun 18.
We report a case of 39-year-old male patient with an unruptured middle cerebral artery aneurysm associated with moyamoya disease (MMD) treated by surgical clipping combined with encephalo-duro-myo-synangiosis surgery.
A 39-year-old male patient with a history of intraventricular hemorrhage was admitted to our hospital. Preoperative digital subtraction angiography (DSA) showed the aneurysm, arising from a collateral branch of the right middle cerebral artery (RMCA), had an extremely thin neck. Also present were an occlusion of the RMCA main trunk, and moyamoya vessels. Microsurgical aneurysm clipping was performed for the aneurysm, while encephalo-duro-myo-synangiosis was performed for ipsilateral MMD. At the 4-month follow-up, the patient had recovered well and DSA indicated improved cerebral perfusion with no de novo aneurysms.
For ipsilateral moyamoya disease accompanied with intracranial aneurysm (IA), simultaneous surgery combining microsurgical clipping and encephalo-duro-myo-synangiosis can be a good treatment option.
我们报告一例39岁男性患者，患有未破裂的大脑中动脉动脉瘤并伴有烟雾病（MMD），采用手术夹闭联合脑-硬膜-肌-血管融合术进行治疗。
一名有脑室内出血病史的39岁男性患者入住我院。术前数字减影血管造影（DSA）显示，动脉瘤起源于右大脑中动脉（RMCA）的一个分支，瘤颈极细。同时还存在RMCA主干闭塞和烟雾状血管。对动脉瘤进行了显微外科夹闭，对同侧烟雾病进行了脑-硬膜-肌-血管融合术。在4个月的随访中，患者恢复良好，DSA显示脑灌注改善，未出现新发动脉瘤。
对于同侧烟雾病合并颅内动脉瘤（IA），显微外科夹闭与脑-硬膜-肌-血管融合术同时进行的联合手术可能是一种较好的治疗选择。
