Hua S E, Gluckman T J, Batjer H H
Division of Neurological Surgery, Northwestern University Medical School, Chicago, Illinois, USA.
Neurosurgery. 1996 Nov;39(5):1050-3; discussion 1053-4. doi: 10.1097/00006123-199611000-00038.
The authors present a case of a subacute middle cerebral artery occlusion that was sustained subsequent to a basilar apex aneurysm clipping via the pterional approach. A middle cerebral artery stroke is a rare complication of basilar bifurcation aneurysm clipping, and, to our knowledge, this complication has not been previously described in otherwise healthy patients with unruptured basilar aneurysms.
A 36-year-old woman was found to have an unruptured 1.6 x 1.0-cm basilar tip aneurysm, as revealed by computed tomography. She elected to undergo surgical repair.
Transsylvian dissection, exposure, and uneventful clipping of the basilar bifurcation aneurysm were performed.
A middle cerebral artery stroke occurring after the repair of an intact basilar aneurysm has several possible causes, including retraction injury and direct surgical injury. Awareness of this complication is important for the early recognition and management of the occlusion before infarction is established.
作者报告一例经翼点入路夹闭基底动脉尖部动脉瘤后发生的大脑中动脉亚急性闭塞病例。大脑中动脉卒中是基底动脉分叉部动脉瘤夹闭术罕见的并发症，据我们所知，此前尚未在其他方面健康的未破裂基底动脉瘤患者中描述过这种并发症。
计算机断层扫描显示，一名36岁女性患有一个1.6×1.0厘米的未破裂基底动脉尖部动脉瘤。她选择接受手术修复。
进行了经侧裂解剖、暴露基底动脉分叉部动脉瘤并顺利夹闭。
完整基底动脉瘤修复后发生大脑中动脉卒中可能有多种原因，包括牵拉损伤和直接手术损伤。认识到这种并发症对于在梗死形成前早期识别和处理闭塞很重要。
