Okada Y, Shima T, Nishida M, Yamane K, Okita S, Hatayama T, Naoe Y, Nishida T
Department of Neurosurgery, Chugoku Rousai Hospital, Kure, Japan.
No To Shinkei. 1994 Mar;46(3):257-62.
We clinicopathoradiologically assessed 15 angiographically diagnosed megadolichobasilar anomalies. Nine of the patients were male and 6 were female; their average age was 61 years. Eleven patients presented with cerebral ischemic attacks, other two complained of trigeminal neuralgia and the remaining two suffered severe headaches. Twelve of the patients had severe hypertension. Vertebral angiography revealed marked elongation of the basilar artery with severe tortuousity and dilatation. The average distance from the dorsum sellae to the basilar artery bifurcation on the lateral view was 24.7 mm, and the average maximum diameter of the basilar artery was 8.6 mm. Aneurysmal dilatation of the basilar artery was also observed in four cases. In 14 of the 15 patients CT scans revealed characteristic findings, such as tubular high density mass with evident contrast enhancement extending from the ventral medulla to the interpeduncular cistern. The outcome was extremely poor, with five deaths and four patients with severe dementia. In the two autopsy cases, enlarged internal lumens could be observed despite severe atheroscrelotic changes, such as intimal thickening by atheromas.
我们对15例经血管造影诊断为巨大延长型基底动脉异常的患者进行了临床病理放射学评估。其中男性9例，女性6例；平均年龄61岁。11例患者出现脑缺血发作，另外2例主诉三叉神经痛，其余2例患有严重头痛。12例患者患有严重高血压。椎动脉造影显示基底动脉明显延长，伴有严重迂曲和扩张。侧位片上从鞍背到基底动脉分叉的平均距离为24.7毫米，基底动脉的平均最大直径为8.6毫米。4例还观察到基底动脉的动脉瘤样扩张。15例患者中有14例CT扫描显示出特征性表现，如从延髓腹侧延伸至脚间池的管状高密度肿块，并伴有明显的对比增强。结果极差，5例死亡，4例患有严重痴呆。在2例尸检病例中，尽管存在严重的动脉粥样硬化改变，如动脉粥样瘤导致的内膜增厚，但仍可观察到管腔扩大。
