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一例经脑血管造影记录显示脑动脉瘤先消失后复发的病例报告(作者译)

[A case presentation in which cerebral aneurysm disappeared then recurred documented by cerebral angiography (author's transl)].

作者信息

Suzuki K, Tone O, Yonemura N, Inaba Y

出版信息

No Shinkei Geka. 1981 Nov;9(12):1433-6.

PMID:7322271
Abstract

A 50-year-old man was admitted to this hospital with an onset one day previously of headache and impaired consciousness. Cerebral angiography performed on the date of admission revealed a middle cerebral artery aneurysm, measuring approximately 7 X 8 X 9 mm. The patient was begun on t-AMCHA 6 g/day, hypotensive agents and anticonvulsants. On the second day after administration, the patient exhibited a temperature of 38 degree C which continued for 3 weeks and was of unknown ethiology. Repeat cerebral angiography was performed two weeks later, and examination of the right carotid artery revealed that the aneurysm had disappeared. Also noted was a slight vasospasm on the internal carotid artery and the peripheral middle cerebral artery from an aneurysm. One week later, another examination confirmed that the aneurysm had indeed disappeared and the vasospasm was decreased. The fourth cerebral angiography was done 32 days after admission and showed definite recurrence of the aneurysm. Surgery and clipping of the aneurysm were done the following day. The postoperative course was uneventful and the patient was discharged from the hospital without neurologic abnormalities. This is the third reported case of the recurrence of an aneurysm that had once disappeared from cerebral angiography. This case may represent an episode of "spontaneous thrombosis" or "spontaneous cure or healing."

摘要

一名50岁男性因一天前出现头痛和意识障碍入院。入院当天进行的脑血管造影显示大脑中动脉瘤,大小约为7×8×9毫米。患者开始接受每天6克的t-AMCHA、降压药和抗惊厥药治疗。给药后第二天,患者体温达到38摄氏度,持续了3周,病因不明。两周后进行了重复脑血管造影,右侧颈动脉检查显示动脉瘤已消失。还注意到动脉瘤部位的颈内动脉和大脑中动脉外周有轻微血管痉挛。一周后,再次检查证实动脉瘤确实消失且血管痉挛减轻。入院32天后进行了第四次脑血管造影,显示动脉瘤明确复发。次日进行了动脉瘤手术夹闭。术后过程顺利,患者出院时无神经功能异常。这是第三例报告的曾在脑血管造影中消失的动脉瘤复发病例。该病例可能代表了“自发性血栓形成”或“自发治愈”的情况。

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