Zwolak R M, Whitehouse W M, Knake J E, Bernfeld B D, Zelenock G B, Cronenwett J L, Erlandson E E, Kazmers A, Graham L M, Lindenauer S M
J Vasc Surg. 1984 May;1(3):415-22.
Twenty-four atherosclerotic extracranial carotid artery aneurysms were encountered in 21 patients during a 25-year period. These represented 46% of all extracranial carotid artery aneurysms diagnosed at the University of Michigan during this period. Neurologic symptoms including amaurosis fugax, transient ischemic attacks, and stroke were present in 50% of the patients. An asymptomatic pulsatile neck mass occurred in 33%. Surgical therapy was undertaken for 18 aneurysms, and nonoperative treatment was pursued in the remaining six aneurysms. Operative therapy included 14 aneurysmectomies and four aneurysmorraphies. There were no surgical deaths. Transient perioperative neurologic deficits affected three of these patients (17%), and one individual (5%) experienced a permanent deficit. Transient cranial nerve deficits occurred in three patients (17%), and a permanent deficit was noted in one patient (5%). During a 7.6-year follow-up period no late strokes occurred among patients who were operated on. Nonoperative therapy was associated with three ipsilateral strokes during a mean follow-up period of 6.3 years. Atherosclerotic extracranial carotid artery aneurysms were associated with an exceptionally high stroke rate (50%) if treated nonoperatively. Prevention of late stroke justifies surgery, although perioperative neurologic deficits may accompany this therapy more often than with nonatherosclerotic carotid artery aneurysms.
在25年期间，21例患者中发现了24个颅外颈动脉粥样硬化性动脉瘤。这些动脉瘤占密歇根大学在此期间诊断出的所有颅外颈动脉动脉瘤的46%。50%的患者出现了包括一过性黑矇、短暂性脑缺血发作和中风在内的神经系统症状。33%的患者有无症状搏动性颈部肿块。18个动脉瘤接受了手术治疗，其余6个动脉瘤采用非手术治疗。手术治疗包括14例动脉瘤切除术和4例动脉瘤缝合术。无手术死亡病例。3例患者（17%）出现短暂性围手术期神经功能缺损，1例患者（5%）出现永久性神经功能缺损。3例患者（17%）出现短暂性颅神经缺损，1例患者（5%）出现永久性颅神经缺损。在7.6年的随访期内，接受手术的患者未发生晚期中风。在平均6.3年的随访期内，非手术治疗与3例同侧中风相关。如果采用非手术治疗，颅外颈动脉粥样硬化性动脉瘤的中风发生率异常高（50%）。尽管围手术期神经功能缺损可能比非动脉粥样硬化性颈动脉动脉瘤更常伴随这种治疗，但预防晚期中风证明手术是合理的。
