1例经血管内手术治疗的双侧大脑前动脉胼胝体上部分（A4-A5）动脉瘤破裂病例
A Case of a Ruptured Aneurysm at the Supracallosal Portion (A4-A5) of the Bihemispheric Anterior Cerebral Artery Treated with Endovascular Surgery.
作者信息
Uchino Kei, Kondo Kosuke, Harada Naoyuki, Aoki Yoshinori, Noguchi Yoshitaka, Oishi Hitoshi, Sugo Nobuo
机构信息
Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.
Department of Neurosurgery, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Kanagawa, Japan.
出版信息
J Neuroendovasc Ther. 2022;16(3):147-151. doi: 10.5797/jnet.cr.2021-0026. Epub 2021 Jul 16.
OBJECTIVE
To report our experience on a rare case of a ruptured aneurysm at the supracallosal portion (A4-A5) of the bihemispheric anterior cerebral artery (ACA), an ACA anomaly, and present that endovascular surgery was a good treatment even for peripheral cerebral aneurysm.
CASE PRESENTATION
A 53-year-old woman experienced a sudden onset of severe headache and vomiting. Plain CT scan revealed subarachnoid hemorrhage and hematoma in the supracallosal area. Cerebral angiography showed that the left pericallosal artery supplied blood to the bilateral parietal lobes through the bihemispheric artery. A saccular aneurysm was found at the supracallosal portion of the left bihemispheric ACA. Coil embolization of the cerebral aneurysm was performed completely.
CONCLUSION
Several reports have demonstrated an aneurysm with bihemispheric ACA, all treated by neck clipping. In this case, endovascular treatment for intracranial peripheral cerebral aneurysms becomes possible, and treatment indications are said to expand.
目的
报告我们关于双半球大脑前动脉（ACA）胼胝体上部分（A4 - A5）动脉瘤破裂这一罕见病例的经验，这是一种ACA异常情况，并表明血管内手术即使对于周围性脑动脉瘤也是一种良好的治疗方法。
病例介绍
一名53岁女性突然出现严重头痛和呕吐。头颅CT平扫显示胼胝体上区域蛛网膜下腔出血和血肿。脑血管造影显示左侧胼周动脉通过双半球动脉向双侧顶叶供血。在左侧双半球ACA的胼胝体上部分发现一个囊状动脉瘤。对脑动脉瘤进行了完全的弹簧圈栓塞。
结论
已有多篇报道显示双半球ACA动脉瘤，均采用夹闭颈部进行治疗。在本病例中，颅内周围性脑动脉瘤的血管内治疗成为可能，且治疗适应证据说有所扩大。
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