Striph G G
Department of Surgery, Toledo Hospital, Ohio.
J Clin Neuroophthalmol. 1993 Sep;13(3):181-7.
A 26-year-old woman presented with a partial left oculomotor nerve palsy and an acute subarachnoid hemorrhage. Bilateral angiography showed a left posterior communicating artery aneurysm and a normal right anterior circulation. The aneurysm was successfully clipped. At 4 1/2 years later, she had an acute, nearly complete, right oculomotor nerve palsy. Repeat bilateral angiography showed a right posterior communicating artery aneurysm, in a previously angiographically normal region, and continued closure of the original left-sided aneurysm. New aneurysms may develop from angiographically normal locations. It is possible that certain patients are more susceptible than average to aneurysm formation or that aneurysm repair leads to a higher rate of new aneurysm occurrence. The previous cases of de novo aneurysms are summarized and the implications for repeat aneurysm screening, using current technology, are discussed.
一名26岁女性出现左侧动眼神经部分麻痹及急性蛛网膜下腔出血。双侧血管造影显示左侧后交通动脉瘤，右侧前循环正常。该动脉瘤成功夹闭。4年半后，她出现急性、几乎完全性的右侧动眼神经麻痹。再次双侧血管造影显示在先前血管造影正常的区域出现右侧后交通动脉瘤，原左侧动脉瘤持续闭合。新的动脉瘤可能从血管造影正常的部位发生。某些患者可能比一般人更容易形成动脉瘤，或者动脉瘤修复导致新动脉瘤发生的几率更高。总结了既往新发动脉瘤的病例，并讨论了使用当前技术进行重复动脉瘤筛查的意义。
