Ishiwada Tadahiro, Noda Mariko, Imae Shogo, Tone Osamu
Department of Neurosurgery, Fujiyoshida Municipal Hospital, Fujiyoshida, JPN.
Department of Neurosurgery, Yamato Tokushukai Hospital, Yamato, JPN.
Cureus. 2025 May 18;17(5):e84353. doi: 10.7759/cureus.84353. eCollection 2025 May.
Blood blister-like aneurysms (BBAs) usually occur on the supraclinoid portion of the internal carotid artery. There are a few reports of BBAs in other locations. We provide the case details of a ruptured BBA of the basilar artery (BA) that was treated with stenting, with a good outcome. The patient was a 74-year-old Japanese woman with a World Federation of Neurosurgical Societies (WFNS) grade I subarachnoid hemorrhage. Digital subtraction angiography (DSA) performed on day 14 revealed a BBA with a maximum diameter of 1.5 mm and a wide neck on the posterior wall of the BA's tip. Single stenting was performed on day 20, and an additional stenting was performed on day 26 due to postoperative stent migration. At six months post-operation, DSA revealed that the aneurysm had disappeared, and the patient was recovering well. Ruptured BBAs of the BA are rare and difficult to treat due to high rates of rebleeding and the presence of significant perforating branches. BBAs located on the posterior wall, in particular, are at high risk of ischemic complications. If coil embolization within an aneurysm is difficult, stenting alone may also be an effective treatment.
血泡样动脉瘤（BBAs）通常发生于颈内动脉床突上段。其他部位的BBAs报道较少。我们提供了1例基底动脉（BA）破裂BBAs患者的病例详情，该患者接受了支架置入治疗，预后良好。患者为一名74岁的日本女性，世界神经外科联合会（WFNS）分级为I级蛛网膜下腔出血。发病第14天行数字减影血管造影（DSA）检查，发现BA尖端后壁有一个最大直径为1.5mm且颈部较宽的BBAs。第20天行单支架置入术，术后因支架移位，于第26天再次行支架置入术。术后6个月，DSA显示动脉瘤消失，患者恢复良好。BA破裂BBAs较为罕见，由于再出血率高且存在重要的穿支血管，治疗困难。特别是位于后壁的BBAs，发生缺血性并发症的风险较高。如果动脉瘤内的弹簧圈栓塞困难，单纯支架置入术也可能是一种有效的治疗方法。
