Hung K S, Lee T C, Lui C C
Department of Neurosurgery, Chang Gung Medical College, Taiwan, Republic of China.
Acta Neurochir (Wien). 1996;138(12):1464-7. doi: 10.1007/BF01411127.
Aneurysm of the superior branch of anterior choroidal artery is very rare. We report this rare case with unique angiographic findings mimicking an internal carotid bifurcation aneurysm. A 35-year-old woman was admitted to our hospital because of severe headache. Lumbar puncture disclosed numerous red blood cells. Computed tomography revealed an enhanced circular area in the left basal cistern with moderate hydrocephalus. Cerebral angiography showed a saccular aneurysm near the left internal carotid bifurcation. During operation, the aneurysm was not found at the internal carotid bifurcation, but located deeper budding from the superior branch of the anterior choroidal artery. The aneurysm was successfully clipped. The postoperative course was favourable without any neurological deficit. The postoperative angiogram showed that the aneurysm was clipped well with preservation of the main trunk of the anterior choroidal artery. Computed tomography of the brain did not show any infarction area, 3 months after the surgery. The uniqueness of this case is the favourable outcome after sacrificing the superior branch of the anterior choroidal artery. The role of collaterals of the anterior perforating substance is emphasized.
脉络膜前动脉上支动脉瘤非常罕见。我们报告这例罕见病例，其具有独特的血管造影表现，酷似颈内动脉分叉处动脉瘤。一名35岁女性因严重头痛入院。腰椎穿刺发现大量红细胞。计算机断层扫描显示左基底池有强化的圆形区域，伴有中度脑积水。脑血管造影显示左颈内动脉分叉处附近有一个囊状动脉瘤。手术中，在颈内动脉分叉处未发现动脉瘤，而是位于脉络膜前动脉上支更深部的膨出处。动脉瘤成功夹闭。术后过程顺利，无任何神经功能缺损。术后血管造影显示动脉瘤夹闭良好，脉络膜前动脉主干得以保留。术后3个月脑部计算机断层扫描未显示任何梗死区域。该病例的独特之处在于牺牲脉络膜前动脉上支后仍取得了良好的预后。强调了前穿质侧支循环的作用。
