Kawai K, Narita K, Nakayama H, Tamura A
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
Neurol Med Chir (Tokyo). 1997 Feb;37(2):184-7. doi: 10.2176/nmc.37.184.
A 19-year-old male presented with intraventricular hemorrhage manifesting as sudden onset of headache. Angiography showed mild stenotic changes in the distal internal carotid artery and proximal anterior cerebral artery only on the right. The anterior choroidal artery and lenticulostriate arteries appeared dilated, and an aneurysm-like shadow was seen in the distal right anterior choroidal artery. He was discharged without treatment. Eighteen months later, he presented with a second intraventricular hemorrhage manifesting as sudden occipitalgia, vomiting, and nausea. He had hyperreflexia of the left extremities and paresthesia of the left upper extremity. Angiography showed marked progression of the vascular abnormalities bilaterally. Moyamoya vessels were also present. He received bilateral encephalo-duro-arterio-myo-synangiosis with good results. Moyamoya disease may cause hemorrhage even at an early stage.
一名19岁男性因突发头痛伴脑室内出血就诊。血管造影显示仅右侧颈内动脉远端和大脑前动脉近端有轻度狭窄改变。脉络膜前动脉和豆纹动脉增粗，右侧脉络膜前动脉远端可见动脉瘤样阴影。他未经治疗出院。18个月后，他再次因突发枕部疼痛、呕吐和恶心出现脑室内出血。他左侧肢体腱反射亢进，左上肢感觉异常。血管造影显示双侧血管异常明显进展。也出现了烟雾状血管。他接受了双侧脑-硬脑膜-动脉-肌-血管吻合术，效果良好。烟雾病即使在早期也可能导致出血。
