Dietz Nicholas, Omair Jasmine, Dang Vivien, John Kevin, Williams Brian J, Abecassis Isaac J, Ding Dale
Neurosurgery, University of Louisville, Louisville, USA.
Radiology, Stony Brook University, Stony Brook, USA.
Cureus. 2025 Jun 9;17(6):e85592. doi: 10.7759/cureus.85592. eCollection 2025 Jun.
Ischemic stroke caused by a thrombosed intracranial aneurysm is a rare clinical condition that presents distinct treatment challenges. We report the case of a 69-year-old woman with vascular comorbidities who was found unresponsive and presented with acute left-sided hemiplegia, aphasia, and rightward gaze deviation. Imaging revealed a large, unruptured, thrombosed aneurysm at the right middle cerebral artery bifurcation, with occlusion of the parent M1 segment. The patient underwent a right pterional craniotomy for resection of the thrombosed aneurysm and surgical clipping of three additional intracranial aneurysms. This case underscores the importance of including aneurysmal thrombosis in the differential diagnosis of ischemic stroke. Although management is complex, surgical resection and clipping of thrombosed aneurysms may offer a viable treatment approach.
由颅内血栓形成性动脉瘤引起的缺血性中风是一种罕见的临床病症，带来了独特的治疗挑战。我们报告了一例69岁患有血管合并症的女性病例，该患者被发现无反应，伴有急性左侧偏瘫、失语和向右凝视偏斜。影像学检查显示，在右侧大脑中动脉分叉处有一个大的、未破裂的血栓形成性动脉瘤，其供血的M1段闭塞。该患者接受了右翼点开颅手术，以切除血栓形成性动脉瘤，并对另外三个颅内动脉瘤进行手术夹闭。该病例强调了在缺血性中风的鉴别诊断中纳入动脉瘤血栓形成的重要性。尽管治疗管理复杂，但对血栓形成性动脉瘤进行手术切除和夹闭可能是一种可行的治疗方法。
