Piepgras D G, McGrail K M, Tazelaar H D
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
J Neurosurg. 1994 May;80(5):909-13. doi: 10.3171/jns.1994.80.5.0909.
An aneurysmal dissection of a right middle cerebral artery (MCA) branch is described in a 56-year-old woman. The abnormality was an incidental finding on computerized tomography and subsequently appeared on magnetic resonance imaging performed to evaluate the patient for subjective pulsatile tinnitus. The intracranial aneurysm was documented to have enlarged on serial angiography over a 6-week interval. Treatment was believed to be necessary because of the unknown etiology of the aneurysm, with the differential diagnosis including mycotic or neoplastic aneurysm with a risk of hemorrhage. The lesion was excised and flow to the distal MCA branch was preserved with an anastomosis of the superficial temporal artery to the MCA. The aneurysm, which developed at the level of the sylvian fissure, proved on pathological study to be related to a focal dissection of the MCA branch. The radiographic appearance and pathological findings are presented. Focal dissection must henceforth be included in the differential diagnosis of peripheral cerebral artery aneurysms.
本文描述了一名56岁女性右大脑中动脉（MCA）分支的动脉瘤样夹层。该异常在计算机断层扫描时为偶然发现，随后在为评估患者主观搏动性耳鸣而进行的磁共振成像中显现。颅内动脉瘤在连续血管造影中显示在6周内有所增大。由于动脉瘤病因不明，鉴别诊断包括霉菌性或肿瘤性动脉瘤且有出血风险，故认为有必要进行治疗。病变被切除，通过颞浅动脉与MCA吻合保留了向MCA远端分支的血流。动脉瘤发生于外侧裂水平，病理研究证实与MCA分支的局灶性夹层有关。文中呈现了影像学表现和病理结果。今后，局灶性夹层必须纳入周围脑动脉动脉瘤的鉴别诊断中。
