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胼胝体发育不全伴奇静脉大脑前动脉动脉瘤破裂及脂肪瘤1例——病例报告

[A case of agenesis of the corpus callosum accompanied by a ruptured azygos anterior cerebral artery aneurysm and lipoma--a case report].

作者信息

Nakamura N, Ogawa A, Kayama T, Sakurai Y, Yoshimoto T, Suzuki J

出版信息

No To Shinkei. 1986 Jul;38(7):701-5.

PMID:3756036
Abstract

A 53-year-old woman suffered from sudden onset of severe headache on February 28 in 1982. She was admitted to our hospital soon after onset. On admission, she had a severe headache and nausea, and her consciousness was drowsy. CT scan showed a marked subarachnoid hemorrhage with intracerebral and intraventricular hematoma, a separation of the lateral ventricles with enlargement of posterior horns, and deformity of anterior horn. By these findings, the patient was diagnosed as an agenesis of the corpus callosum with subarachnoid hemorrhage. Left carotid arteriogram revealed an azygos anterior cerebral artery and an aneurysm at the terminal portion of this artery. Surgery was performed on the 24 th day after subarachnoid hemorrhage. Operative finding revealed a little finger's head-sized tumor was situated over the right frontobasal artery. An azygos anterior cerebral artery aneurysm was clipped and tumor was removed. Pathological diagnosis of the tumor was a lipoma. Namely, she had an agenesis of the corpus callosum, an azygos anterior cerebral artery, an aneurysm and a lipoma. There are some reports in which an agenesis of the corpus callosum is accompanied with a lipoma and an azygos anterior cerebral artery is accompanied with an aneurysm. But a case of agenesis of the corpus callosum with an azygos anterior cerebral artery was rarely reported. So this rare case with these anomalies was reported and pathogenesis about the development of 4 anomalies was also discussed.

摘要

一名53岁女性于1982年2月28日突然出现剧烈头痛。发病后不久即被收入我院。入院时,她头痛剧烈且伴有恶心,意识模糊。CT扫描显示明显的蛛网膜下腔出血伴脑内和脑室内血肿,侧脑室分离伴后角扩大,前角畸形。根据这些发现,该患者被诊断为胼胝体发育不全伴蛛网膜下腔出血。左侧颈动脉造影显示一条奇静脉大脑前动脉及其末端的一个动脉瘤。在蛛网膜下腔出血后第24天进行了手术。手术发现一个小指指头大小的肿瘤位于右额底动脉上方。夹闭了奇静脉大脑前动脉瘤并切除了肿瘤。肿瘤的病理诊断为脂肪瘤。也就是说,她患有胼胝体发育不全、奇静脉大脑前动脉、动脉瘤和脂肪瘤。有一些报道称胼胝体发育不全伴有脂肪瘤,奇静脉大脑前动脉伴有动脉瘤。但胼胝体发育不全合并奇静脉大脑前动脉的病例很少被报道。因此,报告了这一罕见的伴有这些异常的病例,并讨论了这4种异常发育的发病机制。

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