Ide M, Jimbo M, Yamamoto M, Hagiwara S
Department of Neurosurgery, Tokyo Women's Medical College Dai-ni Hospital.
Neurol Med Chir (Tokyo). 1995 Nov;35(11):825-9. doi: 10.2176/nmc.35.825.
A 38-year-old housewife presented with a ruptured aneurysm associated with unilateral internal carotid artery agenesis. She had been in good health until May 31, 1994, when she was admitted to our facility immediately after sudden onset of headache and nausea. She was alert and exhibited no focal neurological deficit on admission. Cerebral angiography demonstrated an aneurysm arising from the junction of the horizontal segment of the right posterior cerebral artery and posterior communicating artery. The right internal carotid artery was totally absent. High resolution computed tomography demonstrated absence of the right carotid canal in the skull base. Neck clipping of the aneurysm was carried out through the right pterional approach on June 2. She returned home 52 days after the surgery with mild paresis of the left upper extremity and has since resumed household activities. Early surgery may be recommended in a patient with a ruptured aneurysm associated with agenesis of the internal carotid artery to prevent catastrophic rebleeding, if the initial insult is mild and subsequent vasospasm is unlikely to occur.
一名38岁的家庭主妇因与单侧颈内动脉发育不全相关的动脉瘤破裂前来就诊。在1994年5月31日之前她一直身体健康，当天她在突然出现头痛和恶心后立即被送往我院。入院时她神志清醒，未表现出局灶性神经功能缺损。脑血管造影显示一个动脉瘤起自右侧大脑后动脉水平段与后交通动脉的交界处。右侧颈内动脉完全缺如。高分辨率计算机断层扫描显示颅底右侧颈动脉管缺如。6月2日通过右侧翼点入路对动脉瘤进行了颈部夹闭术。术后52天她回家，遗留轻度左侧上肢轻瘫，此后已恢复家务活动。对于与颈内动脉发育不全相关的动脉瘤破裂患者，如果初始损伤较轻且随后不太可能发生血管痉挛，为防止灾难性再出血，可能建议早期手术。
