Motuo Fotso M J, Brunon J, Outhel R, Fischer G
Service de Neurochirurgie, hôpital de Bellevue, Saint-Etienne.
Neurochirurgie. 1993;39(4):225-30.
The authors report the case of two sisters: each suffered from two intracranial hemorrhages caused by aneurysmal rupture at an interval of respectively 8 and 5 years. In the first case, the first subarachnoid hemorrhage (SAH) was related to a left middle cerebral artery aneurysm and the second, 8 years later, to the rupture of one of three right aneurysms (anterior communicating, supraclinoid internal carotid and middle cerebral arteries). But the "de novo" character of the right aneurysms could not be established. In the second case, the first SAH was related to an aneurysm of the right middle cerebral artery, with the left one appearing normal on the initial angiography. The second SAH, 5 years later, was related to a "de novo" left aneurysm. These two observations of familial, multiple and "de novo" intracranial aneurysms suggest a genetic basis for the pathogenesis of the arterial dysplasia. As in the literature, these hypothetical congenital factors could not be identified in both cases, but their probability justifies further investigations. If this factor exists, can we hope for a total recovery of the aneurysmal disease?
两人均间隔8年和5年分别因动脉瘤破裂发生两次颅内出血。在第一个病例中，首次蛛网膜下腔出血（SAH）与左侧大脑中动脉动脉瘤有关，第二次出血在8年后，是由右侧三个动脉瘤（前交通动脉、床突上段颈内动脉和大脑中动脉）之一破裂所致。但右侧动脉瘤的“新生”性质无法确定。在第二个病例中，首次SAH与右侧大脑中动脉动脉瘤有关，左侧动脉瘤在初次血管造影时显示正常。5年后的第二次SAH与一个“新生”的左侧动脉瘤有关。这两例家族性、多发性和“新生”颅内动脉瘤病例提示动脉发育异常的发病机制存在遗传基础。与文献报道一样，在这两个病例中均未发现这些假设的先天性因素，但其可能性值得进一步研究。如果这个因素存在，我们能否期望动脉瘤疾病完全康复？
