Ohkata N, Ikota T, Tashiro T, Okamoto K
Department of Neurosurgery, Hokkaido Kin-Ikyo Central Hospital, Sapporo, Japan.
No Shinkei Geka. 1994 Jul;22(7):637-41.
An unusual case of multiple aneurysms of the extracranial vertebral artery associated with neurofibromatosis is presented. A 48-year-old woman, complaining of weakness and numbness of the left upper extremity, was admitted to our hospital on July 27, 1987. She had undergone the removal of a left internal thoracic artery aneurysm due to hemothorax on June 12, 1987. On the next day, the symptoms of the left upper extremity appeared. On admission, general physical examination showed multiple cafe-au-lait spots on her body and cervicothoracic scoliosis. Neurological examination revealed left C5, 6 radiculopathy. Cervical CT scans showed enhanced masses at the transverse foramina. Left subclavian angiography demonstrated multiple extracranial vertebral artery aneurysms from the origin of the vertebral artery to the C4 level. This case was treated by proximal and distal ligation of the aneurysms. Postoperative right and left angiograms revealed no aneurysms filled with contrast materials. The weakness and numbness of the left upper extremity disappeared gradually after the operation.
本文报告了一例罕见的与神经纤维瘤病相关的颅外椎动脉多发动脉瘤病例。一名48岁女性,因左上肢无力和麻木于1987年7月27日入院。她曾于1987年6月12日因血胸接受左胸廓内动脉瘤切除术。次日,出现左上肢症状。入院时,全身体格检查发现其身上有多处咖啡牛奶斑以及颈胸段脊柱侧弯。神经学检查显示左侧C5、6神经根病。颈部CT扫描显示横突孔处有强化肿块。左锁骨下血管造影显示从椎动脉起始处至C4水平的颅外椎动脉多发动脉瘤。该病例采用动脉瘤近端和远端结扎治疗。术后左右血管造影显示无造影剂充盈的动脉瘤。术后左上肢的无力和麻木逐渐消失。