Otsu Yusuke, Miyagi Kohei, Takashima Chihiro, Kikuchi Jin, Kajiwara Sosho, Negoto Tetsuya, Orito Kimihiko, Sakata Kiyohiko, Hirohata Masaru, Morioka Motohiro
Department of Neurosurgery, Kurume University School of Medicine 67, Asahimachi Kurume City, Fukuoka, 830-0011, Japan.
Acta Neurochir (Wien). 2025 Sep 8;167(1):240. doi: 10.1007/s00701-025-06596-3.
We report a 64-year-old woman who developed symptomatic vasospasm on postoperative day 7 after clipping of an unruptured right middle cerebral artery (MCA) aneurysm. Imaging revealed right MCA vasospasm, which resolved with oral antiplatelets and intravenous vasodilators. She was discharged without neurological deficits. Although a few reports describe vasospasm after clipping unruptured aneurysms, this is the first to detail the clinical course, radiological findings, and treatment response. Potential risk factors include female sex, age 40-60, smoking, trigeminal neuralgia, and complex aneurysms. This case underscores the need to consider vasospasm even without subarachnoid hemorrhage for timely intervention.
我们报告了一名64岁女性,她在未破裂的右侧大脑中动脉(MCA)动脉瘤夹闭术后第7天出现了有症状的血管痉挛。影像学检查显示右侧大脑中动脉血管痉挛,通过口服抗血小板药物和静脉注射血管扩张剂后缓解。她出院时没有神经功能缺损。虽然有一些报告描述了未破裂动脉瘤夹闭术后的血管痉挛,但这是第一份详细描述临床过程、影像学表现和治疗反应的报告。潜在的危险因素包括女性、40 - 60岁、吸烟、三叉神经痛和复杂动脉瘤。该病例强调,即使没有蛛网膜下腔出血,也需要考虑血管痉挛以便及时进行干预。