Berger M S, Wilson C B
J Neurosurg. 1984 Nov;61(5):882-94. doi: 10.3171/jns.1984.61.5.0882.
Dissecting aneurysms of the intracranial posterior circulation are unusual lesions that affect otherwise healthy young adults, are difficult to diagnose and manage, and carry a high morbidity and mortality rate. Headache in the suboccipital-posterior cervical region is the most common presenting symptom. The dissection usually occurs between the intima or internal elastic lamina and the media; subadventitial dissection does occur and accounts for the infrequent finding of subarachnoid hemorrhage. A deficit in the inner layers of the vessel is the proposed source of dissection. The angiographic features are inconsistent, although an irregularly narrowed arterial segment with proximal and/or distal dilatation are typical findings. Depending on the location of the dissection, the surgical options are: ligation, trapping, or reinforcement of exposed abnormal portions of the vessel. Anticoagulation therapy is not indicated in the management of this lesion.
颅内后循环夹层动脉瘤是一种不常见的病变，影响原本健康的年轻人，诊断和治疗困难，且发病率和死亡率高。枕下 - 颈后部区域头痛是最常见的首发症状。夹层通常发生在内膜或内弹性膜与中膜之间；外膜下夹层确实会发生，这也是蛛网膜下腔出血少见的原因。血管内层的缺陷被认为是夹层的来源。血管造影特征并不一致，尽管动脉节段不规则狭窄并伴有近端和 / 或远端扩张是典型表现。根据夹层的位置，手术选择包括：结扎、包裹或加固血管暴露的异常部分。抗凝治疗不适用于该病变的管理。
