Rosat P, Deramond H, Grunewald P, Le Gars D, Galibert P
Neurochirurgie. 1981;27(2):133-7.
The spontaneous dissecting aneurysms of the internal cervical carotid artery are renowned unusual, as about fifty cases only are reported in the literature. About 18 cases of dissecting aneurysms, 5 of which operated on and 13 clinically and radiologically followed, the authors try to draw a management. This one is resolutely conservative because: 1. It is possible to expect the spontaneous evolution according to the radiological form of the dissection which becomes in the great majority of cases toward repermeability. 2. The exceptional cases evolving to the thrombosis can later have an extra-intracranial anastomosis. 3. The cases justifying a direct surgical approach are exceptional and the operatory decision is easily taken according to the radiological aspect. On the whole, this pathology seems less unusual than the literature leads to suppose and the spontaneous evolution is worth to be well known because it conditions the management.
颈内动脉自发性夹层动脉瘤非常罕见，文献报道仅有约50例。作者对18例夹层动脉瘤患者进行了研究，其中5例接受了手术治疗，13例进行了临床和影像学随访，并尝试制定治疗方案。该方案坚决采取保守治疗，原因如下：1. 根据夹层的放射学表现，大多数情况下可预期其自发演变至再通，因此可以期待自发转归。2. 极少数发展为血栓形成的病例，后期可进行颅外-颅内吻合术。3. 需要直接手术治疗的病例非常罕见，手术决策可根据放射学表现轻松做出。总体而言，这种疾病似乎不像文献所认为的那么罕见，其自发演变情况值得深入了解，因为这会影响治疗方案的制定。
