Chu Fudi, Song MaoYuan, Zhang Zheng, Pang Chunxiao, Wang JinPeng
School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong.
Department of Neurosurgery, Weifang People's Hospital Affiliated to Weifang Medical University, Weifang, China.
J Craniofac Surg. 2024 Mar 7. doi: 10.1097/SCS.0000000000010010.
The treatment of complex intracranial aneurysms has always been a great challenge in neurosurgery. Craniotomy has a high risk of clipping, there is a risk of rupture at any time, endovascular embolization is relatively low risk, but expensive and easy to relapse, the best treatment needs to be further discussed. Cavernous sinus aneurysms with pituitary adenomas are rare. This case reports a case of complex intracranial aneurysms. Chief complaints are: (1) blepharoptosis with blurred vision for 1 year, (2) headache for 3 days, and (3) digital subtraction angiography showed right internal carotid artery cavernous sinus aneurysm. Combined with the patient's condition and family condition, the external carotid artery-radial artery-middle cerebral artery bypass was selected. After surgical treatment, the symptoms of the patients were improved, the postoperative recovery was good, and the condition was stable. After follow-up, the patient's brain computed tomography showed intra-aneurysm thrombosis.
复杂颅内动脉瘤的治疗一直是神经外科领域的巨大挑战。开颅夹闭术风险高,存在随时破裂的风险,血管内栓塞术风险相对较低,但费用高昂且易于复发,最佳治疗方案仍需进一步探讨。合并垂体腺瘤的海绵窦动脉瘤较为罕见。本病例报告了一例复杂颅内动脉瘤。主要症状为:(1)上睑下垂伴视力模糊1年,(2)头痛3天,(3)数字减影血管造影显示右侧颈内动脉海绵窦段动脉瘤。结合患者病情及家庭情况,选择了颈外动脉-桡动脉-大脑中动脉搭桥术。手术治疗后,患者症状改善,术后恢复良好,病情稳定。随访后,患者脑部计算机断层扫描显示动脉瘤内血栓形成。